Heart failure & cardiomyopathies

Impact of Moderate Aortic Stenosis in Patients With Heart Failure With Reduced Ejection Fraction

J Am Coll CardiolPublished Retrospective cohort study

Main findingResult — go to the resultHazard ratio 1.24 95% CI 1.04–1.49

Authors' conclusion

In patients with HFrEF, moderate AS is associated with increased rates of HF hospitalization and mortality.

Study context

Population
Patients with heart failure with reduced ejection fraction (HFrEF) (left ventricular ejection fraction (LVEF) <50%)
Participants
9,133 patients
Exposure
Moderate aortic stenosis (AS) vs no AS and severe AS
  • Moderate ASn = 374
  • Severe ASn = 362
Outcome
Composite of:
  • All-cause mortality
  • HF hospitalization
Follow-up
Median 3.1 years
Methodological detailspropensity-score matched
  • Propensity-score matched

Main finding

As reported in the abstract

Hazard ratio

1.24

95% CI 1.04–1.49

P = 0.01

By group

Moderate ASvs No AS
HR 1.24 (95% CI 1.04–1.49); P = 0.01

Observational data: associations, not effects.

Further findings

Survival with aortic valve replacement (AVR)

HR (CI)P value
AVRImproved survival0.60 (0.36–0.99)P < 0.05
OutcomeModerate ASSevere ASP value
HF hospitalizationSevere AS vs Moderate AS43.6%36.2%P < 0.05

Heart failure (HF) hospitalization

Severe AS more likely to undergo AVR during follow-up

Days alive outside hospital (matched cohort)

Fewer days alive outside hospital with moderate AS
P < 0.0001
  • Matched cohort

Original publication

Impact of Moderate Aortic Stenosis in Patients With Heart Failure With Reduced Ejection Fraction. J Am Coll Cardiol. Published 4 April 2023. doi:10.1016/j.jacc.2023.01.032

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