Does treatment assignment influence the prognosis of patients with symptomatic severe aortic stenosisReportar como inadecuado

Does treatment assignment influence the prognosis of patients with symptomatic severe aortic stenosis - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Cardiovascular Ultrasound

, 13:2

First Online: 09 January 2015Received: 21 October 2014Accepted: 16 December 2014


ObjectiveAortic valve replacement AVR is the standard therapy in patients with symptomatic aortic stenosis AS. In high surgical risk patients, alternative therapeutic options to medical treatment MT such as trans-catheter aortic valve implantation TAVI or balloon aortic valvuloplasty BAV have been proposed. In this study we evaluated whether treatment assignment influences per se the prognosis of these subjects.

Patients and methodsCriteria for treatment assignment were based on patient’s clinical conditions, Logistic EuroSCORE and other co-morbidities ignored by EuroSCORE. Due to baseline clinical differences between patients with diverse treatment assignment, we used propensity score matching to achieve balance.

Results368 patients were studied: 141 underwent AVR, 127 TAVI, 49 BAV and 51 MT. 84 events deaths for all causes occurred during 14 months of follow-up: 11 AVR 8%, 26 TAVI 20%, 18 MT 35%, 29 BAV group 59%. Traditional Cox analysis identified treatment assignment as independent predictor of events HR 1.82 CI 1.10-3.25 together with lower left ventricular ejection fraction, impaired renal function and history of heart failure. Matched Cox analysis by propensity score confirmed treatment assignment as an independent prognosticator of events HR 1.90 CI 1.27-2.85, and showed similar rate events in TAVI and AVR patients, while it was significantly increased in BAV and MT patients.

ConclusionsTreatment assignment may influence outcome of symptomatic patients with AS.

KeywordsAortic stenosis Aortic valve replacement TAVI Balloon aortic valvuloplasty Prognosis  Download fulltext PDF

Autor: Giovanni Cioffi - Cesare Tomasi - Andrea Rossi - Stefano Nistri - Luigi Tarantini - Giacomo Faden - Carmine Mazzone - Andre


Documentos relacionados