Article (Scientific journals)
Risk Score for Predicting Outcome in Patients With Asymptomatic Aortic Stenosis
Monin, J. L.; Lancellotti, Patrizio; Monchi, M. et al.
2009In Circulation, 120 (1), p. 69-75
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Keywords :
echocardiography; natriuretic peptides; risk score; stenosis; valves
Abstract :
[en] 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)x2]+(natural logarithm of B-type natriuretic peptidex1.5)+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.
Disciplines :
General & internal medicine
Author, co-author :
Monin, J. L.
Lancellotti, Patrizio  ;  Université de Liège - ULiège > Cardiologie
Monchi, M.
Lim, P.
Weiss, E.
Pierard, Luc ;  Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
Guéret, P.
Language :
English
Title :
Risk Score for Predicting Outcome in Patients With Asymptomatic Aortic Stenosis
Publication date :
07 July 2009
Journal title :
Circulation
ISSN :
0009-7322
eISSN :
1524-4539
Publisher :
Lippincott Williams & Wilkins, Hagerstown, United States - Maryland
Volume :
120
Issue :
1
Pages :
69-75
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 22 February 2010

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