Valvular & structural heart disease
Referral patterns and clinical outcomes in patients with severe aortic stenosis: A multicenter cohort study
Authors' conclusion
In this large multicenter study of patients with severe AS, patients with a noncardiac specialty provider were less likely to receive timely cardiac follow-up and AVR, and had higher mortality.
Study context
- Population
- Patients with a first echo diagnosing severe aortic stenosis (AS), 3 health systems, Jan 1, 2019 to Dec 31, 2022median follow-up 552 days
- Participants
- 4,249 patients
- Exposure
- Index echo ordered by noncardiac specialty provider vs cardiology provider
- Outcome
- Composite of:
- Early cardiac follow-up or AVR
- AVR during follow-up
- Mortality
- Follow-up
- Composite within 90 days
Methodological detailsmulticentre, 3 health systems
- Multicentre
- 3 health systems
Main finding
As reported in the abstract
Noncardiac specialty vs CardiologyEstimate (95% CI)
Early cardiac follow-up or AVR
adjusted OR 0.33(0.25–0.43)
AVR
adjusted HR 0.59(0.53–0.66)
Mortality
adjusted HR 1.65(1.44–1.90)
- Achieved composite outcome (all patients)
- 89%
- No aortic valve replacement (AVR) during follow-up (all patients)
- 1,801 (42%)
- No AVR during follow-up, symptomatic patients
- 32%
Observational data: associations, not effects.
Further findings
Low-flow, low-gradient AS (subgroup)
- Discrepancy more pronounced in low-flow, low-gradient AS
Original publication
Referral patterns and clinical outcomes in patients with severe aortic stenosis: A multicenter cohort study. Am Heart J. Published 22 July 2025. doi:10.
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