Document Detail

Risk score for predicting outcome in patients with asymptomatic aortic stenosis.
MedLine Citation:
PMID:  19546391     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The management of patients with asymptomatic severe aortic stenosis remains controversial. We sought to develop a continuous risk score for predicting the midterm development of symptoms or adverse events in this setting. METHODS AND RESULTS: We prospectively followed 107 patients with asymptomatic aortic stenosis (aged 72 years [63 to 77]; 35 women; aortic-jet velocity, 4.1 m/s [3.5 to 4.4]) at a single center in France. Predefined end points for assessing outcome were the occurrence within 24 months of death or aortic valve replacement necessitated by symptoms or by a positive exercise test. Variables independently associated with outcome were used to build a score that was validated in an independent cohort of 107 patients from Belgium. Independent predictors of outcome were female sex, peak aortic-jet velocity, and B-type natriuretic peptide at baseline. Accordingly, the score could be calculated as follows: Score=[peak velocity (m/s) x 2]+(natural logarithm of B-type natriuretic peptide x 1.5)+1.5 (if female sex). Event-free survival after 20 months was 80% for patients within the first score quartile compared with only 7% for the fourth quartile. Areas under the receiver operating characteristic curve for the score were 0.90 and 0.89 in the development and validation cohorts, respectively. CONCLUSIONS: If further validation is achieved, this score may be useful to predict outcome in individual patients with asymptomatic aortic stenosis to select those who might benefit from early surgery.
Jean-Luc Monin; Patrizio Lancellotti; Mehran Monchi; Pascal Lim; Emmanuel Weiss; Luc Piérard; Pascal Guéret
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2009-06-22
Journal Detail:
Title:  Circulation     Volume:  120     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-07     Completed Date:  2009-07-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  69-75     Citation Subset:  AIM; IM    
Department of Cardiology, Henri Mondor Hospital, 51 avenue De Lattre de Tassigny, 94010 Créteil, France.
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MeSH Terms
Aortic Valve / surgery
Aortic Valve Stenosis / mortality*,  surgery,  ultrasonography*
Echocardiography, Doppler*
Exercise Test
Follow-Up Studies
Heart Valve Prosthesis
Kaplan-Meiers Estimate
Middle Aged
Predictive Value of Tests
Preoperative Care
Prospective Studies
Risk Assessment / methods,  standards
Risk Factors
Severity of Illness Index*
Comment In:
Circulation. 2009 Jul 7;120(1):9-11   [PMID:  19581520 ]

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