Prevalence of comorbidities and associated cardiac diseases in patients with valve aortic stenosis. Potential implications for the decision-making process

Faggiano, Pompilio; Frattini, Silvia; Zilioli, Valentina; Rossi, Andrea; Nistri, Stefano; Dini, Frank Loyd; Lorusso, Roberto; Tomasi, Cesare; Dei, Livio

doi:10.1016/j.ijcard.2011.02.026

Cited by 86 publications

(57 citation statements)

References 35 publications

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“…[3][4][5] This entity is rare in the general population, but it has an increasing incidence in older patients and in patients with coronary artery disease (CAD) or aortic stenosis (AS). 6,7 The clinical relevance is based on the fact that it can complicate surgical aortic valve replacement (SAVR) for the treatment of severe AS by preventing safe access via the ascending aorta. PA is associated with increased morbidity and mortality, especially as a result of increased perioperative stroke risk.…”

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confidence: 99%

Porcelain Aorta

et al. 2015

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Porcelain Aorta

et al. 2015

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“…As also demonstrated in the present study, AS patients had a significant burden of comorbidities including a high prevalence of prior myocardial infarction. 18,19 The matched control population had almost comparable high event rates, which may support the notion that comorbidities, rather than AS per se, are driving the high perioperative risks seen for AS patients undergoing noncardiac surgery. The adjusted odds ratio estimates for AS were, however, significant and comparable to those of kidney disease or peripheral artery disease, which underpin that AS needs to be regarded as an independent risk factor for adverse cardiovascular outcomes in noncardiac surgery, especially if symptomatic.…”

Section: Discussionmentioning

confidence: 70%

Noncardiac Surgery in Patients With Aortic Stenosis: A Contemporary Study on Outcomes in a Matched Sample From the Danish Health Care System

Andersson

Jørgensen

Martinsson

et al. 2014

Clinical Cardiology

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BackgroundPast research has identified aortic stenosis (AS) as a major risk factor for adverse outcomes in noncardiac surgery; however, more contemporary studies have questioned the grave prognosis. To further our understanding of this, the risks of a 30‐day major adverse cardiovascular event (MACE) and all‐cause mortality were investigated in a contemporary Danish cohort.HypothesisAS is not an independent risk factor for adverse outcomes in noncardiac surgery.MethodsAll patients with and without diagnosed AS who underwent noncardiac surgery in 2005 to 2011 were identified through nationwide administrative registers. AS patients (n = 2823; mean age, 75.5 years, 53% female) were matched with patients without AS (n = 2823) on propensity score for AS and surgery type.ResultsIn elective surgery, MACE (ie, nonfatal myocardial infarction, ischemic stroke, or cardiovascular death) occurred in 66/1772 (3.7%) of patients with AS and 52/1772 (2.9%) of controls (P = 0.19), whereas mortality occurred in 67/1772 (3.8%) AS patients and 51/1772 (2.9%) controls (P = 0.13). In emergency surgery, 163/1051 (15.5%) AS patients and 120/1051 (11.4%) controls had a MACE (P = 0.006), whereas 225/1051 (21.4%) vs 179/1051 (17.0%) AS patients and controls died, respectively (P = 0.01). Event rates were higher for those with symptoms (defined as use of nitrates, congestive heart failure, or use of loop diuretics), compared with those without symptoms (P < 0.0001).ConclusionsAS is associated with high perioperative rates of MACE and mortality, but perhaps prognosis is, in practice, not much worse for patients with AS than for matched controls. Symptomatic patients and patients undergoing emergency surgery are at considerable risks of a MACE and mortality.

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“…Accordingly, it can be also stated that there is a possibility for a common genetic basis for the association between bicuspid aortic valve disease and coronary heart disease. It is interesting that degenerative-calcific aortic stenosis, which predominantly affects older people, is a presentation of atherosclerosis (Faggiano et al, 2011;Otto et al, 1999;Branch et al, 2002). However, according to our knowledge, there are no studies in the literature reporting such an association for aortic stenosis of rheumatic origin or due to bicuspid valves and for aortic regurgitation or aortic dilatation of any origin.…”

Section: Discussionmentioning

confidence: 99%

A Case-Control Investigation of the Relationship Between Bicuspid Aortic Valve Disease and Coronary Heart Disease

Akkuş¹

2011

Aortic Valve

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Prevalence of comorbidities and associated cardiac diseases in patients with valve aortic stenosis. Potential implications for the decision-making process

Cited by 86 publications

References 35 publications

Porcelain Aorta

Porcelain Aorta

Noncardiac Surgery in Patients With Aortic Stenosis: A Contemporary Study on Outcomes in a Matched Sample From the Danish Health Care System

A Case-Control Investigation of the Relationship Between Bicuspid Aortic Valve Disease and Coronary Heart Disease

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