Valvular & structural heart disease
Definition and Validation of Prognostic Phenotypes in Moderate Aortic Stenosis
PerformanceResult — go to the resultHazard ratio 2.00 95% CI 1.54–2.59Authors' conclusion
Moderate AS has several phenotypes, and multiple comorbidities are the key drivers of adverse outcomes in patients with moderate AS. Outcomes of patients with noncalcified moderate AS were not altered by AVR in these groups.
Study context
- Population
- Patients with moderate aortic stenosis (AS)training n = 2,469
- Comparison
- Prognostic clusters of moderate AS
- Outcome
- Composite of:
- Cardiac death
- HF hospitalisation
- AV intervention
- Follow-up
- 5 years
Methodological detailsunsupervised clustering
- Unsupervised clustering
Performance
As reported in the abstract
Hazard ratio
2.00
95% CI 1.54–2.59
P < 0.001
CV-comorbid
HR 2.00 (95% CI 1.54–2.59); P < 0.001
- Four clusters with significantly different outcomes, identified and replicated
- log-rank P < 0.0001 in both data sets
Further findings
Outcomes after aortic valve replacement (AVR), calcified aortic valve (AV) cluster (subgroup)
| HR (95% CI) | P value | ||
|---|---|---|---|
| AVRValidation · limited by low rate of AVR | 0.21 (0.08–0.57) | P = 0.002 | |
| 0.050.21520Hazard ratio (log scale) |
- No significant effect of AVR on outcomes in the other 3 clusters
Original publication
Definition and Validation of Prognostic Phenotypes in Moderate Aortic Stenosis. JACC Cardiovasc Imaging. Published 14 August 2024. doi:10.
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