RT Journal Article
T1 Prospective registry of symptomatic severe aortic stenosis in octogenarians: a need for intervention.
A1 Martínez-Sellés, M
A1 Gómez Doblas, J J
A1 Carro Hevia, A
A1 García de la Villa, B
A1 Ferreira-González, I
A1 Alonso Tello, A
A1 Andión Ogando, R
A1 Ripoll Vera, T
A1 Arribas Jiménez, A
A1 Carrillo, P
A1 Rodríguez Pascual, C
A1 Casares i Romeva, M
A1 Borras, X
A1 Cornide, L
A1 López-Palop, R
K1 Ageing
K1 Aortic stenosis
K1 Aortic surgery
K1 Anciano de 80 o más años
K1 Estenosis de la válvula aórtica
K1 Implantación de prótesis de válvulas cardíacas
K1 Cateterismo cardíaco
K1 Causas de muerte
K1 Pronóstico
AB OBJECTIVETo study the factors associated with choice of therapy and prognosis in octogenarians with severe symptomatic aortic stenosis (AS).STUDY DESIGNProspective, observational, multicenter registry. Centralized follow-up included survival status and, if possible, mode of death and Katz index.SETTINGTransnational registry in Spain.SUBJECTSWe included 928 patients aged ≥80 years with severe symptomatic AS.INTERVENTIONSAortic-valve replacement (AVR), transcatheter aortic-valve implantation (TAVI) or conservative therapy.MAIN OUTCOME MEASURESAll-cause death.RESULTSMean age was 84.2 ± 3.5 years, and only 49.0% were independent (Katz index A). The most frequent planned management was conservative therapy in 423 (46%) patients, followed by TAVI in 261 (28%) and AVR in 244 (26%). The main reason against recommending AVR in 684 patients was high surgical risk [322 (47.1%)], other medical motives [193 (28.2%)], patient refusal [134 (19.6%)] and family refusal in the case of incompetent patients [35 (5.1%)]. The mean time from treatment decision to AVR was 4.8 ± 4.6 months and to TAVI 2.1 ± 3.2 months, P < 0.001. During follow-up (11.2-38.9 months), 357 patients (38.5%) died. Survival rates at 6, 12, 18 and 24 months were 81.8%, 72.6%, 64.1% and 57.3%, respectively. Planned intervention, adjusted for multiple propensity score, was associated with lower mortality when compared with planned conservative treatment: TAVI Hazard ratio (HR) 0.68 (95% confidence interval [CI] 0.49-0.93; P = 0.016) and AVR HR 0.56 (95% CI 0.39-0.8; P = 0.002).CONCLUSIONOctogenarians with symptomatic severe AS are frequently managed conservatively. Planned conservative management is associated with a poor prognosis.
PB Wiley
SN 0954-6820
YR 2014
FD 2014-06
LK http://hdl.handle.net/10668/2027
UL http://hdl.handle.net/10668/2027
LA en
NO Martínez-Sellés M, Gómez Doblas JJ, Carro Hevia A, García de la Villa B, Ferreira-González I, Alonso Tello A, et al. Prospective registry of symptomatic severe aortic stenosis in octogenarians: a need for intervention. J. Intern. Med.. 2014                         ; 275(6):608-20
NO Journal Article;
DS RISalud
RD Apr 6, 2025