1. Concomitant Mitral Regurgitation in Severe Aortic Stenosis - Insights From the CURRENT AS Registry-2.
- Author
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Obayashi Y, Takeji Y, Taniguchi T, Morimoto T, Shirai S, Kitai T, Tabata H, Ohno N, Murai R, Osakada K, Murata K, Nakai M, Tsuneyoshi H, Tada T, Amano M, Watanabe S, Shiomi H, Watanabe H, Yoshikawa Y, Nishikawa R, Yamamoto K, Toyofuku M, Tatsushima S, Kanamori N, Miyake M, Nakayama H, Nagao K, Izuhara M, Nakatsuma K, Inoko M, Fujita T, Kimura M, Ishii M, Usami S, Nakazeki F, Togi K, Inuzuka Y, Ando K, Komiya T, Ono K, Minatoya K, and Kimura T
- Subjects
- Humans, Aged, Male, Aged, 80 and over, Female, Heart Failure mortality, Heart Failure therapy, Heart Valve Prosthesis Implantation mortality, Risk Factors, Hospitalization, Incidence, Aortic Valve Stenosis surgery, Aortic Valve Stenosis mortality, Aortic Valve Stenosis complications, Aortic Valve Stenosis epidemiology, Aortic Valve Stenosis physiopathology, Registries, Mitral Valve Insufficiency mortality, Mitral Valve Insufficiency physiopathology, Mitral Valve Insufficiency epidemiology, Transcatheter Aortic Valve Replacement mortality, Severity of Illness Index
- Abstract
Background: Data on concomitant mitral regurgitation (MR) in patients with severe aortic stenosis (AS) are scarce.Methods and Results: We investigated the risk of concomitant MR in patients with severe AS in the CURRENT AS Registry-2 according to initial treatment strategy (transcatheter aortic valve implantation [TAVI], surgical aortic valve replacement [SAVR], or conservative). Among 3,365 patients with severe AS, 384 (11.4%) had moderate/severe MR (TAVI: n=126/1,148; SAVR: n=68/591; conservative: n=190/1,626). The cumulative 3-year incidence for death or heart failure (HF) hospitalization was significantly higher in the moderate/severe than no/mild MR group in the entire population (54.6% vs. 34.3%, respectively; P<0.001) and for each treatment strategy (TAVI: 45.0% vs. 31.8% [P=0.006]; SAVR: 31.9% vs. 18.7% [P<0.001]; conservative: 67.8% vs. 41.6% [P<0.001]). The higher adjusted risk of moderate/severe MR relative to no/mild MR for death or HF hospitalization was not significant in the entire population (hazard ratio [HR] 1.15; 95% confidence interval [CI] 0.95-1.39; P=0.15); however, the risk was significant in the SAVR (HR 1.92; 95% CI 1.04-3.56; P=0.04) and conservative (HR 1.30; 95% CI 1.02-1.67; P=0.04) groups, but not in the TAVI group (HR 1.03; 95% CI 0.70-1.52; P=0.86), despite no significant interaction (P
interaction =0.37)., Conclusions: Moderate/severe MR was associated with a higher risk for death or HF hospitalization in the initial SAVR and conservative strategies, while the association was less pronounced in the initial TAVI strategy.- Published
- 2024
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