Heart failure & cardiomyopathies
Epidemiology and Outcomes of Aortic Stenosis in Acute Decompensated Heart Failure: The ARIC Study
Authors' conclusion
Among patients who have experienced an ADHF hospitalization, AS is prevalent and portends poor mortality outcomes. Notably, mild/moderate AS is independently associated with 1-year mortality in this high-risk population.
Study context
- Population
- Residents ≥55 years hospitalised for acute decompensated HF in 4 US communities (ARIC), 2005–2014weighted n=16,692 hospitalisations
- Participants
- 3,597 residents
- Exposure
- Aortic stenosis (AS) vs no AS, by left ventricular ejection fraction (LVEF) subgroup
- Outcome
- AS prevalence and association of AS severity with mortality
- Follow-up
- 1 year
Methodological detailscommunity surveillance, multivariable logistic regression, 4 US communities
- Community surveillance
- Multivariable logistic regression
- 4 US communities
Main finding
As reported in the abstract
AS prevalence; AS severity and 1-year mortality
Higher AS severityOdds ratio (95% CI)
1-year mortality, LVEF <50%
1.16(1.04–1.28)
1-year mortality, LVEF ≥50%
1.40(1.28–1.54)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| AS, Black vs White patientsBlackvs WhiteLVEF <50% | 0.34 (0.28–0.42) | |
| AS, Black vs White patientsBlackvs WhiteLVEF ≥50% | 0.51 (0.44–0.59) | |
| 0.20.5125Odds ratio (log scale) |
Mild/moderate AS and 1-year mortality (sensitivity analysis excluding severe AS)
| OR (95% CI) | ||
|---|---|---|
| Mild/moderate ASLVEF <50% · sensitivity analysis | 1.23 (1.02–1.47) | |
| Mild/moderate ASLVEF ≥50% · sensitivity analysis | 1.31 (1.14–1.51) | |
| 0.512Odds ratio (log scale) |
Original publication
Epidemiology and Outcomes of Aortic Stenosis in Acute Decompensated Heart Failure: The ARIC Study. Circ Heart Fail. Published 3 February 2023. doi:10.
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