A risk prediction model in asymptomatic patients with severe aortic stenosis: CURRENT-AS risk score

被引：10

作者：

Minamino-Muta, Eri ^{[1
]}

Kato, Takao ^{[1
]}

Morimoto, Takeshi ^{[2
]}

Taniguchi, Tomohiko ^{[1
]}

Ando, Kenji ^{[3
]}

Kanamori, Norio ^{[4
]}

Murata, Koichiro ^{[5
]}

Kitai, Takeshi ^{[6
]}

Kawase, Yuichi ^{[7
]}

Miyake, Makoto ^{[8
]}

Izumi, Chisato ^{[9
]}

Mitsuoka, Hirokazu ^{[10
]}

Kato, Masashi ^{[11
]}

Hirano, Yutaka ^{[12
]}

Matsuda, Shintaro ^{[1
]}

Nagao, Kazuya ^{[13
]}

Murakami, Tomoyuki ^{[14
]}

Takeuchi, Yasuyo ^{[15
]}

Yamane, Keiichiro ^{[16
]}

Toyofuku, Mamoru ^{[17
]}

Ishii, Mitsuru ^{[18
]}

Inoko, Moriaki ^{[19
]}

Ikeda, Tomoyuki ^{[20
]}

Ishii, Katsuhisa ^{[21
]}

Hotta, Kozo ^{[22
]}

Jinnai, Toshikazu ^{[23
]}

Kato, Yoshihiro ^{[24
]}

Inuzuka, Yasutaka ^{[25
]}

Maeda, Chiyo ^{[26
]}

Morikami, Yuko ^{[27
]}

Saito, Naritatsu ^{[1
]}

Minatoya, Kenji ^{[28
]}

Kimura, Takeshi ^{[1
]}

机构：

[1] Kyoto Univ, Dept Cardiovasc Med, Grad Sch Med, Sakyo Ku, 54 Shogoin Kawahara Cho, Kyoto 6068507, Japan

[2] Hyogo Coll Med, Dept Clin Epidemiol, 1-1 Mukogawa Cho, Nishinomiya, Hyogo 6638501, Japan

[3] Kokura Mem Hosp, Dept Cardiol, Kokurakita Ku, 3-2-1 Asano, Fukuoka 8028555, Japan

[4] Shimada Municipal Hosp, Div Cardiol, 1200-5 Noda, Shizuoka 4278502, Japan

[5] Shizuoka City Shizuoka Hosp, Dept Cardiol, Aoi Ku, 10-93 Otemachi, Shizuoka 4208630, Japan

[6] Kobe City Med Ctr, Dept Cardiovasc Med, Gen Hosp, Chuo Ku, 2-1-1 Minatojimaminamimachi, Kobe, Hyogo 6500047, Japan

[7] Kurashiki Cent Hosp, Dept Cardiovasc Med, 1-1-1 Miwa, Kurashiki, Okayama 7108602, Japan

[8] Tenri Hosp, Dept Cardiol, Tenri, Nara, Japan

[9] Natl Cerebral & Cardiovasc Ctr, Div Heart Failure, 200 Mishima Cho, Tenri, Nara 6328555, Japan

[10] Kinki Univ, Nara Hosp, Div Cardiol, Fac Med, 1248-1 Otoda Cho, Nara 6300293, Japan

[11] Mitsubishi Kyoto Hosp, Dept Cardiol, Nishigyo Ku, Katsuragosho Cho, Kyoto 6158087, Japan

[12] Kinki Univ Hosp, Dept Cardiol, 377-2 Ohno Higashi, Sayama, Osaka 5898511, Japan

[13] Osaka Red Cross Hosp, Dept Cardiovasc Ctr, Tennoji Ku, 30 Hudegasaki, Osaka 5438555, Japan

[14] Koto Mem Hosp, Dept Cardiol, 1 Hiramatsu Cho, Higashioumi, Shiga 5270134, Japan

[15] Shizuoka Prefectural Gen Hosp, Dept Cardiol, Aoi Ku, 27-1 Kitaando Cho, Shizuoka 4208257, Japan

[16] Nishikobe Med Ctr, Dept Cardiol, Nishi Ku, 5-7-1 Kojida, Kobe, Hyogo 6512273, Japan

[17] Japanese Red Cross Wakayama Med Ctr, Dept Cardiol, 4-20 Komatsubara Dori, Wakayama 6408558, Japan

[18] Natl Hosp Org Kyoto Med Ctr, Dept Cardiol, Fushimi Ku, 1-1 Fukakusamukaihata Cho, Osaka 5308480, Japan

[19] Kitano Hosp, Cardiovasc Ctr, Tazuke Kofukai Med Res Inst, Kita Ku, 2-4-20 Ohgimachi, Osaka 5308480, Japan

[20] Hikone Municipal Hosp, Dept Cardiol, 1882 Yasaka Cho, Hikone, Shiga 5228539, Japan

[21] Kansai Elect Power Hosp, Dept Cardiol, Fukushima Ku, 2-1-7 Fukushima, Osaka 5530003, Japan

[22] Hyogo Prefectural Amagasaki Gen Med Ctr, Dept Cardiol, 2-17-77 Higashi Naniwa Cho, Amagasaki, Hyogo 6608550, Japan

[23] Japanese Red Cross Otsu Hosp, Dept Cardiol, 1-1-35 Nagara, Otsu, Shiga 5200046, Japan

[24] Saiseikai Noe Hosp, Dept Cardiol, Joto Ku, 1-3-25 Furuichi, Osaka 5360001, Japan

[25] Shiga Med Ctr Adults, Dept Cardiol, 5-4-3 Moriyama, Moriyama, Shiga 5248524, Japan

[26] Hamamatsu Rosai Hosp, Dept Cardiol, 25 Shogen Cho, Hamamatsu, Shizuoka 4308525, Japan

[27] Hirakata Kohsai Hosp, Dept Cardiol, 1-2-2-1 Hujisakahigashi Cho, Hirakata, Osaka 5730153, Japan

[28] Kyoto Univ, Dept Cardiovasc Surg, Grad Sch Med, Sakyo Ku, 54 Shogoin Kawahara Cho, Kyoto 6068507, Japan

来源：

EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES | 2020年 / 6卷 / 02期

关键词：

Severe aortic stenosis; Asymptomatic; Risk prediction model; VENTRICULAR EJECTION FRACTION; LONG-TERM SURVIVAL; EUROPEAN-ASSOCIATION; CHAMBER QUANTIFICATION; VALVE IMPLANTATION; AMERICAN-SOCIETY; ANEMIA; ECHOCARDIOGRAPHY; OUTCOMES; SURGERY;

D O I：

10.1093/ehjqcco/qcz044

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims Early aortic valve replacement (AVR) might be beneficial in selected high-risk asymptomatic patients with severe aortic stenosis (AS), considering their poor prognosis when managed conservatively. This study aimed to develop and validate a clinical scoring system to predict AS-related events within 1 year after diagnosis in asymptomatic severe AS patients. Methods and results We analysed 1274 asymptomatic severe AS patients derived from a retrospective multicentre registry enrolling consecutive patients with severe AS in Japan (CURRENT AS registry), who were managed conservatively and completed 1-year follow-up without AVR. From a randomly assigned derivation set (N = 849), we developed CURRENT AS risk score for the AS-related event (a composite of AS-related death and heart failure hospitalization) within 1 year using a multivariable logistic regression model. The risk score comprised independent risk predictors including left ventricular ejection fraction <60%, haemoglobin <= 11.0 g/dL, chronic lung disease (2 points), diabetes mellitus, haemodialysis, and any concomitant valve disease (1 point). The predictive accuracy of the model was good with the area under the curve of 0.79 and 0.77 in the derivation and validation sets (N = 425). In the validation set, the 1-year incidence of AS-related events was much higher in patients with score >= 2 than in patients with score <= 1 (Score 0: 2.2%, Score 1: 1.9%, Score 2: 13.4%, Score 3: 14.3%, and Score >= 4: 22.7%, P< 0.001). Conclusion The CURRENT-AS risk score integrating clinical and echocardiographic factors well-predicted the risk of AS-related events at 1 year in asymptomatic patients with severe AS and was validated internally.

引用

页码：166 / 174

页数：9

共 40 条

[1] Impact of pre- and post-procedural anemia on the incidence of acute kidney injury and 1-year mortality in patients undergoing transcatheter aortic valve implantation (from the French Aortic National CoreValve and Edwards 2 [FRANCE 2] Registry) [J].