Long-Term Outcomes in Aortic Stenosis: Mortality Analysis in a Selected Patient Group

Area of Science:

• Cardiology
• Valvular Heart Disease
• Epidemiology

Background:

• Aortic stenosis (AS) is a common acquired heart valve disease, particularly in older adults.
• Gender-specific differences in AS presentation, comorbidities, and outcomes require further investigation for personalized treatment.
• Understanding these differences is crucial for optimizing patient care and improving survival rates.

Purpose of the Study:

• To analyze clinical and demographic characteristics, comorbidities, and survival outcomes in patients with AS.
• To stratify AS patients by gender and aortic valve morphology (bicuspid aortic valve [BAV] vs. tricuspid aortic valve [TAV]).
• To identify factors influencing survival in AS patients.

Main Methods:

• Retrospective analysis of 145,454 echocardiographic examinations (2009-2018).
• Inclusion criteria: Vmax ≥ 2.0 m/s, age ≥ 18 years (84,851 patients).
• Survival analysis over 16 years (2009-2025) using Kaplan-Meier, with statistical comparisons via STATISTICA v. 10.0.

Main Results:

• AS patients (men: 4998, women: 6322) were older and had higher blood pressure than non-AS patients.
• Men with AS had higher hyperlipidemia rates; women had increased coronary artery disease, diabetes mellitus, and obesity.
• Bicuspid aortic valve (BAV) was more prevalent (54.5% men, 66.4% women); overall mortality reached 21.7% over 16 years.

Conclusions:

• Mortality in AS patients is significant (21.7%), influenced by age, aortic regurgitation, increased jet velocity, and aortic diameter.
• Beta-blocker therapy improved survival, while ARB/CCB combinations were detrimental.
• Aortic valve replacement showed an insignificant effect; absence of anticoagulants and presence of antiarrhythmics/statins correlated with better outcomes.