Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Valvular Heart Disease
Comprehensive Risk Stratification of Japanese Patients With Aortic Stenosis – A Proposal of a New Risk Score From the CHART-2 Study –
Kenjiro SatoYasuhiko SakataMasanobu MiuraSoichiro TadakiRyoichi UshigomeTakeshi YamauchiTakeo OnoseKanako TsujiRuri AbeKotaro NochiokaJun TakahashiSatoshi MiyataHiroaki Shimokawaon behalf of the CHART-2 Investigators
Author information
JOURNAL FREE ACCESS FULL-TEXT HTML
Supplementary material

2015 Volume 79 Issue 7 Pages 1631-1638

Details
Abstract

Background:The risk of patients with aortic stenosis (AS) should be stratified not only by AS severity but also by comorbidities.Methods and Results:We aimed to develop a risk score for mortality in 412 patients with AS (pressure gradient ≥30 mmHg, mean age 74.9 years, male 52.4%) in the CHART-2 Study (n=10,219). During a 3-year follow-up, 73 (17.7%) patients died. Crude 3-year mortality of patients in New York Heart Association (NYHA) classes I, II, and III/IV was 9.5%, 16.5%, and 49.7%, respectively (P<0.001). Stepwise Cox regression analysis showed that the combination of 7 factors was the best model to predict the mortality of AS patients, who were scored according to their hazard ratios, including NYHA class III–IV (score 6), male sex (3), serum albumin level ≤4 g/dl (2), aortic peak flow ≥4.5 m/s (2), age ≥75 years (2), chronic kidney disease (2), and anemia (1). Receiver-operating characteristic analysis showed excellent association between the sum of the scores and 3-year mortality (area under the curve, 0.78). The multivariate Cox proportional hazard model demonstrated that the present risk score also well stratified the mortality risk.Conclusions:The present study demonstrates that, in addition to the classical prognostic factors related to symptoms and AS severity, various comorbidities are associated with mortality. Thus, the present comprehensive risk score may be useful for risk stratification of AS patients. (Circ J 2015; 79: 1631–1638)

Content from these authors
© 2015 THE JAPANESE CIRCULATION SOCIETY
Previous article Next article
feedback
Top