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Poggio, Paolo; Cavallotti, Laura; Myasoedova, Veronika A.; Bonomi, Alice; Songia, Paola; Gripari, Paola; Valerio, Vincenza; Amato, Mauro; Barbieri, Simone; Faggiano, Pompilio; Alamanni, Francesco; Veglia, Fabrizio; Pepi, Mauro; Tremoli, Elena; Baldassarre, Damiano

Aortic Valve Sclerosis Adds to Prediction of Short-Term Mortality in Patients with Documented Coronary Atherosclerosis

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  • Medientyp: E-Artikel
  • Titel: Aortic Valve Sclerosis Adds to Prediction of Short-Term Mortality in Patients with Documented Coronary Atherosclerosis
  • Beteiligte: Poggio, Paolo; Cavallotti, Laura; Myasoedova, Veronika A.; Bonomi, Alice; Songia, Paola; Gripari, Paola; Valerio, Vincenza; Amato, Mauro; Barbieri, Simone; Faggiano, Pompilio; Alamanni, Francesco; Veglia, Fabrizio; Pepi, Mauro; Tremoli, Elena; Baldassarre, Damiano
  • Erschienen: MDPI AG, 2019
  • Erschienen in: Journal of Clinical Medicine
  • Sprache: Englisch
  • DOI: 10.3390/jcm8081172
  • ISSN: 2077-0383
  • Schlagwörter: General Medicine
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:p>Aims: Aortic valve sclerosis (AVSc), a non-uniform thickening of leaflets with an unrestricted opening, is characterized by inflammation, lipoprotein deposition, and matrix degradation. In the general population, AVSc predicts long-term cardiovascular mortality (+50%) even after adjustment for vascular risk factors and clinical atherosclerosis. We have hypothesized that AVSc is a risk-multiplier able to predict even short-term mortality. To address this issue, we retrospectively analyzed 90-day mortality of all patients who underwent isolated coronary artery bypass grafting (CABG) at Centro Cardiologico Monzino over a ten-year period (2006–2016). Methods: We analyzed 2246 patients and 90-day all-cause mortality was 1.5% (31 deaths). We selected only patients deceased from cardiac causes (n = 29) and compared to alive patients (n = 2215). A cardiologist classified the aortic valve as no-AVSc (n = 1352) or AVSc (n = 892). Cox linear regression and integrated discrimination improvement (IDI) analyses were used to evaluate AVSc in predicting 90-day mortality. Results: AVSc 90-day survival (97.6%) was lower than in no-AVSc (99.4%; p &lt; 0.0001) with a hazard ratio (HR) of 4.0 (95%CI: 1.78, 9.05; p &lt; 0.0001). The HR for AVSc, adjusted for propensity score, was 2.7 (95%CI: 1.17, 6.23; p = 0.02) and IDI statistics confirmed that AVSc significantly adds (p &lt; 0.001) to the identification of high-risk patients than EuroSCORE II alone. Conclusion: Our data supports the hypothesis that a risk stratification strategy based on AVSc, added to ESII, may allow better recognition of patients at high-risk of short-term mortality after isolated surgical myocardial revascularization. Results from this study warrant further confirmation.</jats:p>
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