Valvular & structural heart disease
Cardiac Damage Staging Predicts Outcomes in Aortic Valve Stenosis After Aortic Valve Replacement: Meta-Analysis
Authors' conclusion
In patients undergoing AVR across the symptomatic and severity spectrum of AS, cardiac damage staging at baseline has important prognostic implications.
Study context
- Population
- Patients with aortic stenosis (AS) undergoing surgical or transcatheter aortic valve replacement (AVR)
- Participants
- 14,499 patients · 16 studies
- Comparison
- Cardiac damage stages 1–4 vs stage 0
- Outcome
- All-cause mortality
Methodological detailsKaplan-Meier-derived reconstructed individual time-to-event data
- Kaplan-Meier-derived reconstructed individual time-to-event data
Pooled result
As reported in the abstract
All-cause mortality, symptomatic severe AS (n = 12,282) · 5 years
Each group vs stage 0Hazard ratio (95% CI)P value
Stage 1
1.30(1.03–1.64)
P = 0.029Stage 2
1.74(1.41–2.16)
P < 0.001Stage 3
2.92(2.35–3.64)
P < 0.001Stage 4
3.51(2.79–4.41)
P < 0.001Further pooled results
| Outcome | Stage 0 | Stage 1 | Stage 2 | Stage 3 to 4 | HR (95% CI) | P value | |
|---|---|---|---|---|---|---|---|
| All-cause mortality, asymptomatic moderate/severe AS (n = 2,217) · 8 years — Stage 1 vs Stage 0 | 19.3% | 36.9% | 51.7% | 67.8% | 1.70 (1.21–2.38) | P = 0.002 | |
| All-cause mortality, asymptomatic moderate/severe AS (n = 2,217) · 8 years — Stage 2 vs Stage 0 | 2.20 (1.60–3.02) | P < 0.001 | |||||
| All-cause mortality, asymptomatic moderate/severe AS (n = 2,217) · 8 years — Stage 3 to 4 vs Stage 0 | 3.90 (2.79–5.47) | P < 0.001 | |||||
| 0.20.5125Hazard ratio (log scale) |
Original publication
Cardiac Damage Staging Predicts Outcomes in Aortic Valve Stenosis After Aortic Valve Replacement: Meta-Analysis. JACC Adv. Published 22 May 2024. doi:10.
Summarised from the published abstract; every number is checked against it