Article (Scientific journals)
Contemporary Management of Severe Symptomatic Aortic Stenosis.
Eugène, Marc; Duchnowski, Piotr; Prendergast, Bernard et al.
2021In Journal of the American College of Cardiology, 78 (22), p. 2131-2143
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Keywords :
Aged; Aged, 80 and over; Aortic Valve/diagnostic imaging/surgery; Aortic Valve Stenosis/diagnosis/epidemiology/surgery; Clinical Decision-Making; Disease Management; Echocardiography; Europe/epidemiology; Female; Follow-Up Studies; Humans; Male; Morbidity/trends; Retrospective Studies; Risk Assessment/methods; Risk Factors; Severity of Illness Index; Transcatheter Aortic Valve Replacement/methods; Treatment Outcome; aortic stenosis; decision making; guidelines; surgical aortic valve replacement; transcatheter aortic valve replacement
Abstract :
[en] BACKGROUND: There were gaps between guidelines and practice when surgery was the only treatment for aortic stenosis (AS). OBJECTIVES: This study analyzed the decision to intervene in patients with severe AS in the EORP VHD (EURObservational Research Programme Valvular Heart Disease) II survey. METHODS: Among 2,152 patients with severe AS, 1,271 patients with high-gradient AS who were symptomatic fulfilled a Class I recommendation for intervention according to the 2012 European Society of Cardiology guidelines; the primary end point was the decision for intervention. RESULTS: A decision not to intervene was taken in 262 patients (20.6%). In multivariate analysis, the decision not to intervene was associated with older age (odds ratio [OR]: 1.34 per 10-year increase; 95% CI: 1.11 to 1.61; P = 0.002), New York Heart Association functional classes I and II versus III (OR: 1.63; 95% CI: 1.16 to 2.30; P = 0.005), higher age-adjusted Charlson comorbidity index (OR: 1.09 per 1-point increase; 95% CI: 1.01 to 1.17; P = 0.03), and a lower transaortic mean gradient (OR: 0.81 per 10-mm Hg decrease; 95% CI: 0.71 to 0.92; P < 0.001). During the study period, 346 patients (40.2%, median age 84 years, median EuroSCORE II [European System for Cardiac Operative Risk Evaluation II] 3.1%) underwent transcatheter intervention and 515 (59.8%, median age 69 years, median EuroSCORE II 1.5%) underwent surgery. A decision not to intervene versus intervention was associated with lower 6-month survival (87.4%; 95% CI: 82.0 to 91.3 vs 94.6%; 95% CI: 92.8 to 95.9; P < 0.001). CONCLUSIONS: A decision not to intervene was taken in 1 in 5 patients with severe symptomatic AS despite a Class I recommendation for intervention and the decision was particularly associated with older age and combined comorbidities. Transcatheter intervention was extensively used in octogenarians.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Eugène, Marc;  Cardiology Department, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris,
Duchnowski, Piotr;  Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland.
Prendergast, Bernard;  Department of Cardiology, St Thomas' Hospital, London, United Kingdom.
Wendler, Olaf;  Department of Cardiothoracic Surgery, King's College Hospital, London, United
Laroche, Cécile;  EURObservational Research Programme, European Society of Cardiology,
Monin, Jean-Luc;  Cardiology Department, Institut Mutualiste Montsouris, Paris, France.
Jobic, Yannick;  Cardiology Department, Hôpital Cavale Blanche, Brest, France.
Popescu, Bogdan A;  Department of Cardiology, University of Medicine and Pharmacy Carol
Bax, Jeroen J;  Department of Cardiology, Leiden University Medical Center, Leiden, the
Vahanian, Alec;  Université de Paris, Paris, France.
Iung, Bernard;  Cardiology Department, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris,
EORP VHD II Registry Investigators, Group
Other collaborator :
Iung, Bernard
Bax, Jeroen
De Bonis, Michele
Delgado, Victoria
Haude, Michael
Hindricks, Gerhard
Maggioni, Aldo P
Pierard, Luc
Popescu, Bogdan A
Prendergast, Bernard
Price, Susanna
Yuzbashova, Madina
Gallego, Pastora
Mendez, Irene
Villegas, David Villagomez
Correa, Manuel Gonzalez
Calvo, Roman
Florian, Francisco
Paya, Rafael
Esteban, Esther
Buendia, Francisco
Cubillos, Andrés
Zamanov, Vuqar
Fernandez, Carmen
Cárdenas, Juan Pablo
Pérez-Boscá, José Leandro
Vano, Joan
Belchi, Joaquina
Iglesia-Carreno, Cristina
Iglesias, Francisco Calvo
Escudero-Gonzalez, Aida
Zapateria-Lucea, Sergio
Duarte, Juan Sterling
Mammadov, Vusal
Perez-Davila, Lara
Iglesias, Francisco Calvo
Cobas-Paz, Rafael
Besada-Montenegro, Rosario
Fontao-Romeo, Maribel
Lopez-Rodriguez, Elena
Paredes-Galan, Emilio
Caneiro-Queija, Berenice
Gonzalez, Alba Guitian
Bozkurt, Abdi
Van Camp, Gery
Demir, Serafettin
Unlu, Durmus
Cagliyan, Caglar Emre
Ikikardes, Muslum Firat
Tangalay, Mustafa
Kuloglu, Osman
Ozer, Necla
Canpolat, Ugur
Kemaloglu, Melek Didem
Demirtas, Abdullah Orhan
Penicka, Martin
Akgün, Didar Elif
Avci, Eyup
Taylan, Gokay
Yilmaztepe, Mustafa Adem
Ucar, Fatih Mehmet
Altay, Servet
Gurdogan, Muhammet
Gudul, Naile Eris
Aktas, Mujdat
Buyuklu, Mutlu
Batjoens, Hedwig
Degirmenci, Husnu
Turan, Mehmet Salih
Mert, Kadir Ugur
Mert, Gurbet Ozge
Dural, Muhammet
Dogan, Sait Mesut
Arslan, Sukru
Sayar, Nurten
Kanar, Batur
Sadic, Beste Ozben
Debonnaire, Philippe
Sahin, Ahmet Anil
Buyuk, Ahmet
Kilicarslan, Onur
Bostan, Cem
Yildirim, Tarik
Yildirim, Seda Elcim
Cosansu, Kahraman
Cosansu, Kahraman
Varim, Perihan
Ilguz, Ersin
Dendooven, Daniel
Demirbag, Recep
Yesilay, Asuman
Cirit, Abdullah
Tusun, Eyyup
Erkus, Emre
Sayin, Muhammet Rasit
Kazaz, Zeynep
Kul, Selim
Karabag, Turgut
Kalayci, Belma
Knecht, Sebastien
Duytschaever, Mattias
Rosenhek, Raphael
Vandekerckhove, Yves
Missault, Luc
Muyldermans, Luc
Tavernier, René
De Grande, Tineke
Coussement, Patrick
DeTroyer, Joyce
Derycker, Katrien
De Jaegher, Kelly
Bondue, Antoine
Ruschitzka, Frank
Beauloye, Christophe
Goffinet, Céline
Mirica, Daniela Corina
Bondue, Antoine
Eynden, Frédéric Vanden
Van de Borne, Philippe
Van Frachen, Béatrice
Vancraeynest, David
Vanoverschelde, Jean Louis
Pierard, Sophie
Vahanian, Alec
Malanca, Mihaela
Sinnaeve, Florence
Tahon, Séverine
De Clippel, Marie
Gayet, Frederic
Loiseau, Jacques
Van de Veire, Nico
Moerman, Veronique
Willems, Anne-Marie
Cosyns, Bernard
Wendler, Olaf
Droogmans, Steven
Motoc, Andreea
Kerkhove, Dirk
Plein, Daniele
Roosens, Bram
Weytjens, Caroline
LANCELLOTTI, Patrizio  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Pierard, Luc
Dulgheru, Elena Raluca
Parenicova, Ilona
Windecker, Stephan
Bedanova, Helena
Tousek, Frantisek
Sindelarova, Stepanka
Canadyova, Julia
Taborsky, Milos
Ostransky, Jiri
Ivona, Simkova
Vicha, Marek
Jelinek, Libor
Opavska, Irena
Mekhaldi, Souad
Homza, Miroslav
Kvrayola, Miriam
Brat, Radim
Mrozek, Dan
Lichnerova, Eva
Docekalova, Iveta
Linhartova, Katerina
Zarybnicka, Marta
Peskova, Marketa
Roucka, Patrik
Lemaitre, Katell
Stastna, Vlasta
Vondrackova, Dagmar Jungwirtova
Hornig, Alfred
Niznansky, Matus
Branny, Marian
Vodzinska, Alexandra
Dorda, Miloslav
Snkouril, Libor
Kluz, Krystyna
Kypusova, Jana
Authier, Sébastien
Nezvalova, Radka
Ihlemann, Nikolaj
Olsen, Niels Thue
Ali, Hosam Hasan
Taha, Salma
Hassan, Mohamed
Afifi, Ahmed
Kabil, Hamza
Mady, Amr
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Ahmed, Yasser
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Talaat, Islam
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Horvath, Andras
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Berisha, Gezim
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Aleksi, Jorida
Percuku, Luan
Berisha, Gezim
Arapova, Rano
Laahunova, Elmira
Neronova, Kseniia
Zhakypova, Zarema
Naizabekova, Gulira
Muratova, Gulnazik
Arapova, Rano
Sime, Iveta
Knuti, Gerti
Sorokins, Nikolajs
Erglis, Andrejs
Kamzola, Ginta
Cgojeva-Sproge, Irina
Rancane, Gita
Valentinaviciene, Ramune
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Mizariene, Vaida
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Verseckaite, Raimonda
Zvirblyte, Ruta
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Radauskaite, Greta
Janaviciute-Matuzeviciene, Gabija
Jancauskaite, Dovile
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Maneikyte, Juste
Mileryte, Ingrida
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Xuereb, Robert George
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Tomkiewicz-Pajak, Lidia
Sliwiak, Dorota
Sobien, Bartosz
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Gancarczyk, Urszula
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Sorysz, Danuta
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Cieply, Malgorzata
Misiuda, Agnieszka
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Sedziwy, Ewa
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Hryniewiecki, Tomasz
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Gina, Mirald
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Grabowski, Maciej
Duchnowski, Piotr
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Zaborska, Beata
Pilichowska-Paskiet, Ewa
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Slomski, Tomasz
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Martins, Rui
Quintal, Nuno
Mendes, Bruno
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Silva, Joseline
Ferreira, Joao
Milner, James
Alves, Patricia
Marinho, Vera
Gago, Paula
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Bento, Dina
Machado, Inocencia
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Oliveira, Margarida
Calvo, Lucy
von Hate, Pedro
Faria, Bebiana
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Almeida, Joao
Rodrigues, Alberto
Sigmund, Elisabeth
Braga, Pedro
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Carvalho, Sofia
Ferreira, Catarina
Ferreira, Alberto
Mateus, Pedro
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Leao, Silvia
Margato, Renato
Moreira, Ilidio
Ploechl, Andrea
Guimanaes, Jose
Ribeiro, Joana
Goncalves, Fernando
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Almeida, Ines
Goncalves, Luisa
Tarusi, Mariana
Pop, Calin
Matei, Claudia
Tint, Diana
Sturmberger, Thomas
Barbulescu, Sanziana
Micu, Sorin
Pop, Ioana
Baba, Costica
Dimulescu, Doina
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Ginghina, Carmen
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Ghilencea, Liviu
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Stoian, Monica
Oprescu, Nicoleta
Iancovici, Silvia
Petre, Iona
Mateescu, Anca Doina
Koppler, Tanja
Calin, Andreea
Botezatu, Simona
Enache, Roxana
Rosca, Monica
Ciuperca, Daniela
Botezatu, Simona
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Cadis, Laura
Rancea, Raluca
Mascherbauer, Julia
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Rosianu, Adela
Kovacs, Emese
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Craciun, Alina
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Grigorica, Lucica
Dragusin, Daniela
Nechita, Luiza
Heger, Maria
Marinescu, Mihai
Chiscaneanu, Teodor
Botezatu, Lucia
Corciova, Costela
Petris, Antoniu Octavian
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Salaru, Delia
Alexandrescu, Dan Mihai
Plesoianu, Carmjen
Tanasa, Ana
Kammerlander, Andreas
Mitu, Ovidiu
Costache, Irina Iuliana
Tudorancea, Ionut
Usurelu, Catalin
Eminovici, Gabriela
Manitiu, Ioan
Stoia, Oana
Mitre, Adriana
Nistor, Dan-Octavian
Maier, Anca
Duca, Franz
Lupu, Silvia
Opris, Mihaela
Ionac, Adina
Popescu, Irina
Crisan, Simina
Mornos, Cristian
Goanta, Flavia
Gruescu, Liana
Voinescu, Oana
Petcu, Madalina
Binder, Christina
Cozlac, Ramona
Damrina, Elena
Khilova, Liliya
Ryazantseva, Irina
Kozmin, Dmitry
Kiseleva, Maria
Goncharova, Marina
Kitalaeva, Kamila
Demetskay, Victoria
Verevetinov, Artem
Koschutnik, Matthias
Fomenko, Mikhail
Skripkina, Elena
Tsoi, Viktor
Antipov, Georgii
Schneider, Yuri
Yazikov, Denis
Makarova, Marina
Cherkes, Aleksei
Ermakova, Natalya
Medvedev, Aleksandr
Perschy, Leonard
Sarosek, Anastasia
Isayan, Mikhail
Voronova, Tatyana
Kulumbegov, Oleg
Tuchina, Alina
Stefanov, Sergei
Klimova, Margarita
Smolyaninov, Konstantin
Dandarova, Zhargalma
Magamet, Victoriya
Puskas, Lisa
Spiropulos, Natalia
Boldyrev, Sergey
Barbukhatty, Kirill
Buyankov, Dmitrii
Yurin, Vladimir
Gross, Yuriy
Boronin, Maksim
Yurin, Vladimir
Mikhaleva, Mariya
Shablovskaya, Mariya
Ho, Chen-Yu
Zotov, Alex
Borisov, Daniil
Tereshchenko, Vasily
Zubova, Ekaterina
Kuzmin, A
Tarasenko, Ivan
Gamzaev, Alishir
Borovkova, Natalya
Koroleva, Tatyana
Botova, Svetlana
Aliyev, Farid
Pochinka, Ilya
Dunaeva, Vera
Teplitskaya, Victoria
Bogachev-Prokophiev, Alexander
Semenova, Elena I
Korabel'Nikova, Olga V
Simonov, Denis S
Denisenko, Elena
Harina, Natalia
Yarohno, Natalia
Guluzada, Vugar
Alekseeva, Svetlana
Abydenkova, Julia
Shabalkina, Lyubov
Mayorova, Olga
Tsechanovich, Valeriy
Medvedev, Igor
Tsechanovich, Valeriy
Tsechanovich, Valeriy
Medvedev, Igor
Lepilin, Michail
Imanov, Galib
Nemchenko, PenzaEvgenii
Karnahin, Vadim
Safina, Vasilya
Slastin, Yaroslav
Gilfanova, Venera
Gorbunov, Roman
Jakubov, Ramis
Fazylova, Aigul
Poteev, Mansur
Vazetdinova, Laysan
Ibrahimov, Firdovsi
Tarasova, Indira
Irgaliyev, Rishat
Moiseeva, Olga
Gordeev, Mikhail
Irtyuga, Olga
Irtyuga, Olga
Moiseeva, Raisa
Ostanina, Nina
Zverev, Dmitry
Murtazalieva, Patimat
Abbasaliyev, Abbasali
Kuznetsov, Dmitry
Skurativa, Mariya
Polyaeva, Larisa
Kuznetsov, Dmitry
Mihaiilov, Kirill
Obrenovic-Kircanski, Biljana
Putnik, Svetozar
Simic, Dragan
Petrovic, Milan
Nikolic, Natasa Markovic
Ahmedov, Tahir
Jovovic, Ljiljana
Ostric, Dimitra Kalimanovska
Brajovic, Milan
Manojlovic, Milica Dekleva
Novakovic, Vladimir
Zamaklar-Trifunovic, Danijela
Orbovic, Bojana
Petrovic, Olga
Boricic-Kostic, Marija
Andjelkovic, Kristina
Muslumova, Fargana
Milanov, Marko
Despotovic-Nikolic, Maja
Budisavljevic, Sreten
Veljkovic, Sanja
Cvetinovic, Nataša
Lepojevic, Daniijela
Todorovic, Aleksandra
Andjelkovic, Kristina
Nikolic, Aleksandra
Borzanovic, Branislava
Babayev, Jamil
Trkulja, Ljiljana
Tomic, Slobodan
Vukovic, Milan
Milosavljevic, Jelica
Milanovic, Mirjana
Stakic, Vladan
Cvetkovic, Aleksandra
Milutinovic, Suzana
Bozic, Olivera
Miladinovic, Miodrag
Rustamova, Yasmin
Nikolic, Zoran
Despotovic, Dinka
Jovanovic, Dimitrije
Stojsic-Milosavljevic, Anastazija
Ilic, Aleksandra
Sladojevic, Mirjana
Susak, Stamenko
Maletin, Srdjan
Pavlovic, Salvo
Kuzmanovic, Vladimir
Jahangirov, Tofig
Ivanovic, Nikola
Dejanovic, Jovana
Ruzicic, Dusan
Drajic, Dragana
Cvetanovic, Danijel
Mirkovic, Marija
Omoran, Jon
Margoczy, Roman
Sedminova, Katarina
Simkova, Iveta
Samadov, Rauf
Reptova, Adriana
Baranova, Eva
Valkovicova, Tatiana
Reptova, Adriana
Valocik, Gabriel
Kurecko, Marian
Vachalcova, Marianna
Kollarova, Alzbeta
Studencan, Martin
Alusik, Daniel
Samadov, Fuad
Kozlej, Marek
Macakova, Jana
Evangelista, Arturo
Moral, Sergio
Cladellas, Merce
Luiso, Daniele
Calvo, Alicia
Palet, Jordi
Carballo, Juli
Tura, Gisela Teixido
Museyibov, Muxtar
Maldonado, Giuliana
Gutierrez, Laura
Gonzalez-Alujas, Teresa
Jose Fernando, Rodriguez Palomares
Villalva, Nicolas
Molina-Mora, Ma Jose
Paton, Ramon Rubio
Martinez Diaz, Juan Jose
Ruiz, Pablo Ramos
Valle, Alfonso
Isayev, Elnur
Rodriguez, Ana
Alania, Edgardo
Galcera, Emilio
Seller, Julia
Valenzuela, Gonzalo de la Morena
Espin, Daniel Saura
Garcia, Dolores Espinosa
Oliva Sandoval, Maria Jose
Gonzalez, Josefa
Navarro, Miguel Garcia
Musayev, Oktay
Perez-Martinez, Maria Teresa
Ortega Trujillo, Jose Ramon
Gallego, Irene Menduina
San Roman, Daniel
Perez Nogales, Eliu David
Medina, Olga
Montiel Quintero, Rodolfo Antonio
Bujanda Morun, Pablo Felipe
Perez, Marta Lopez
Huaripata, Jimmy Plasencia
Xalilov, Shahin
Morales Gonzalez, Juan Jose
Nelson, Veronica Quevedo
Zamorano, Jose Luis
Gomez, Ariana Gonzalez
Fraile, Alfonso
Alberca, Maria Teresa
Martin, Joaquin Alonso
Fernandez-Golfin, Covadonga
Ramos, Javier
Jimenez, Sergio Hernandez
Huseynov, Saleh
Mitroi, Cristina
Sanchez Fernandez, Pedro L
Diaz-Pelaez, Elena
Garde, Beatriz
Caballero, Luis
Garcia, Fermin Martinez
Cambronero, Francisco
Castro, Noelia
Castro, Antonio
De La Rosa, Alejandro
More authors (1070 more) Less
Language :
English
Title :
Contemporary Management of Severe Symptomatic Aortic Stenosis.
Publication date :
30 November 2021
Journal title :
Journal of the American College of Cardiology
ISSN :
0735-1097
eISSN :
1558-3597
Publisher :
Elsevier, Nl
Volume :
78
Issue :
22
Pages :
2131-2143
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Available on ORBi :
since 24 May 2022

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