Conservative management in very elderly patients with severe aortic stenosis: Time to change?

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dc.contributor.author Bernal, Eva
dc.contributor.author Ariza Solé, Albert
dc.contributor.author Formiga, Francesc
dc.contributor.author Abu-Assi, Emad
dc.contributor.author Carol, Antoni
dc.contributor.author Galian Gay, Laura
dc.contributor.author Bayés Genís, Antoni
dc.contributor.author González Saldivar, Hugo
dc.contributor.author Díez-Villanueva, Pablo
dc.contributor.author Martínez Sellés Oliveria Soares, Manuel
dc.date.accessioned 2016-12-13T12:55:42Z
dc.date.available 2016-12-13T12:55:42Z
dc.date.issued 2017
dc.identifier.citation Bernal, E., Ariza-Solé, A., Formiga, F., Abu-Assi, E., Carol, A., Galián, L., ... & Sellés, M. M. (2017). Conservative management in very elderly patients with severe aortic stenosis: Time to change? Journal of cardiology, 69(6), 883-887. spa
dc.identifier.issn 09145087
dc.identifier.uri http://hdl.handle.net/11268/6086
dc.description.abstract Despite current recommendations, a high percentage of patients with severe symptomatic aortic stenosis are managed conservatively. The aim of this study was to study symptomatic patients undergoing conservative management from the IDEAS registry, describing their baseline clinical characteristics, mortality, and the causes according to the reason for conservative management. Consecutive patients with severe aortic stenosis diagnosed at 48 centers during January 2014 were included. Baseline clinical characteristics, echocardiographic data, Charlson index, and EuroSCORE-II were registered, including vital status and performance of valve intervention during one-year follow-up. For the purpose of this substudy we assessed symptomatic patients undergoing conservative management, including them in 5 groups according to the reason for performing conservative management [I: comorbidity/frailty (128, 43.8%); II: dementia 18 (6.2%); III: advanced age 34 (11.6%); IV: patients’ refusal 62 (21.2%); and V: other reasons 50 (17.1%)]. We included 292 patients aged 81.5 ± 9 years. Patients from group I had higher Charlson index (4 ± 2.3), higher EuroSCORE-II (7.5 ± 6), and a higher overall (42.2%) and non-cardiac mortality (16.4%) than the other groups. In contrast, patients from group III had fewer comorbidities, lower EuroSCORE-II (4 ± 2.5), and low overall (20.6%) and non-cardiac mortality (5.9%). Patients with severe symptomatic aortic stenosis managed conservatively have different baseline characteristics and clinical course according to the reason for performing conservative management. A prospective assessment of comorbidity and other geriatric syndromes might contribute to improve therapeutic strategy in this clinical setting. spa
dc.description.sponsorship SIN FINANCIACIÓN spa
dc.language.iso eng spa
dc.title Conservative management in very elderly patients with severe aortic stenosis: Time to change? spa
dc.type article spa
dc.description.impact 2.918 JCR (2017) Q2, 53/128 Cardiac and Cardiovascular Systems spa
dc.identifier.doi 10.1016/j.jjcc.2016.08.009
dc.rights.accessRights closedAccess spa
dc.subject.uem Estenosis aórtica spa
dc.subject.uem Ancianos - Salud e higiene spa
dc.subject.unesco Enfermedad cardiovascular spa
dc.subject.unesco Anciano spa
dc.description.filiation UEM spa
dc.peerreviewed Si spa

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