Table 2.
Clinical outcomes: Symptomatic versus Asymptomatic patients.
| Symptomatic patients Number of patients with event (Cumulative 5-Year Incidence) N = 1215 |
Asymptomatic patients Number of patients with event (Cumulative 5-Year Incidence) N = 1808 |
Unadjusted HR (95% CI) |
P Value | Adjusted HR (95% CI) |
P Value | |
|---|---|---|---|---|---|---|
| Composite of aortic valve-related death or hospitalization due to HF | 315 (32.3%) | 391(27.6%) | 1.29 (1.11–1.49) | <0.001 | 1.64 (1.41–1.96) | <0.001 |
| All-cause death | 425 (39.4%) | 582 (37.5%) | 1.15 (0.98–1.26) | 0.09 | 1.34 (1.16–1.54) | <0.001 |
| Cardiovascular death | 279 (27.9%) | 348 (25.0%) | 1.23 (1.05–1.44) | 0.01 | 1.42 (1.19–1.69) | <0.001 |
| Aortic valve-related death | 156 (16.1%) | 210 (16.6%) | 1.14 (0.92–1.40) | 0.23 | 1.38 (1.10–1.74) | 0.006 |
| Aortic valve-procedure death | 31 (2.7%) | 24 (2.0%) | 1.98 (1.16–3.37) | 0.01 | N/A | — |
| Sudden death | 53 (5.2%) | 90 (7.0%) | 0.90 (0.64–1.26) | 0.54 | 1.11 (0.76–1.62) | 0.59 |
| Non-cardiovascular death | 146 (16.0%) | 234 (16.7%) | 0.95 (0.77–1.17) | 0.61 | 1.19 (0.94–1.50) | 0.16 |
| HF hospitalization | 250 (28.2%) | 294 (21.5%) | 1.37 (1.15–1.62) | <0.001 | 1.85 (1.54–2.24) | <0.001 |
| Surgical AVR or TAVI | 755 (71.9%) | 679 (50.7%) | 2.63 (2.37–2.92) | <0.001 | N/A | — |
The number of patients with event was counted through the entire follow-up period, while the cumulative 5-year incidence was truncated at 5-year.
Any death during hospitalization for AVR or TAVI was regarded as aortic procedure-related death. Aortic valve-related death included aortic procedure-related death, sudden death, and death due to HF. HF hospitalization was defined as hospitalization due to worsening HF requiring intravenous drug therapy.
Risk-adjusting variables: Initial AVR strategy and 18 clinically relevant risk-adjusting variables: age, sex, body mass index, hypertension, current smoking, diabetes on insulin, coronary artery disease, prior myocardial infarction, prior symptomatic stroke, aorta/peripheral artery disease, serum creatinine, hemodialysis, anemia, liver cirrhosis, malignancy currently under treatment, chronic lung disease, any valvular disease, and AS severity.
AS = aortic stenosis; AVR = aortic valve replacement; CI = confidence interval; HF = heart failure; HR = hazard ratio; N/A = not assessed; TAVI = transcatheter aortic valve implantation.