Valvular & structural heart diseaseCohort study
The Mortality Burden of Untreated Aortic Stenosis
- Retrospective cohort study
- multicentre
- real-world database
Authors' conclusion
Patients with AS have high mortality risk across all levels of untreated AS severity.
Study context
- Population
- Adults (>18 years) with echocardiographic aortic stenosis (AS) severity assessment, 24 US hospitalswith AS severity assessment
- Participants
- 595,120 adults
- Exposure
- Untreated AS severity categories vs no AS
- Outcome
- Untreated all-cause mortality (KM estimate, unadjusted)
- Follow-up
- 4 years
Main finding
As reported in the abstract
Untreated all-cause mortality
Observational data: associations, not effects.
Further findings
Kaplan-Meier (KM)-estimated 4-year observed treatment rate, by AS severity (none, mild, mild-to-moderate, moderate, moderate-to-severe, severe, respectively)
- None
- 0.2% (95% CI: 0.2%-0.2%)
- Mild
- 1.0% (95% CI: 0.7%-1.3%)
- Mild-to-moderate
- 4.2% (95% CI: 2.0%-6.3%)
- Moderate
- 11.4% (95% CI: 9.5%-13.3%)
- Moderate-to-severe
- 36.7% (95% CI: 31.8%-41.2%)
- Severe
- 60.7% (95% CI: 58.0%-63.3%)
- values in the order of AS severity, as printed ("respectively")
4-year mortality adjusted for informative censoring caused by treatment
- Results similar to unadjusted
All-cause mortality after multivariate adjustment
- All degrees of AS severity associated with increased mortality
Original publication
The Mortality Burden of Untreated Aortic Stenosis. J Am Coll Cardiol. Published 24 October 2023. doi:10.1016/j.jacc.2023.09.796
Summarised from the published abstract; every number is checked against it