Evidence map›Paper›PMID 36208655›Full record

ArticleJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography2023

Risk for Mortality with Increasingly Severe Aortic Stenosis: An International Cohort Study.

Geoff Strange, Simon Stewart, David Playford, Jordan B Strom

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
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  4. Article
  5. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 3 countries.

Geoff StrangeFaculty of Medicine and Health, University of Sydney, Sydney, Australia; Institute of Health Research, University of Notre Dame, Fremantle, Australia; Heart Research Institute, Sydney, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
Simon StewartInstitute of Health Research, University of Notre Dame, Fremantle, Australia; School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom.
David PlayfordInstitute of Health Research, University of Notre Dame, Fremantle, Australia.
Jordan B StromDepartment of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: jstrom@bidmc.harvard.edu.
The University of Notre Dame Australia · AUDeaconess Hospital · USRoyal Prince Alfred Hospital · AU

Funding

Chronic Renal Insufficiency and Silent Progression of Aortic Stenosis (CRISP-AS)R01HL169517 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI Jordan Blair Strom · 2023 to 2026
$3.1M
Identification of the Components of Frailty Using Administrative Data and Metabolite ProfilingK23HL144907 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI STROM, JORDAN BLAIR · 2019 to 2023
$1.0M
NHLBI NIH HHS K23 HL144907NHLBI NIH HHS R01 HL169517
6 · The paper itself

Abstract

backgroundAortic stenosis (AS) is the most common valvular heart disease in high-income countries. Adjusted for clinical confounders, the risk associated with increasing AS severity across the spectrum of AS severity remains uncertain.

methodsThe authors conducted an international, multicenter, parallel-cohort study of 217,599 Australian (mean age, 76.0 ± 7.3 years; 49.3% women) and 30,865 US (mean age, 77.4 ± 7.3 years; 52.2% women) patients aged ≥65 years who underwent echocardiography. Patients with previous aortic valve replacement were excluded. The risk of increasing AS severity, quantified by peak aortic velocity (Vmax), was assessed through linkage to 97,576 and 14,481 all-cause deaths in Australia and the United States, respectively.

resultsThe distribution of AS severity (mean Vmax, 1.7 ± 0.7 m/sec) was similar in both cohorts. Compared with those with Vmax of 1.0 to 1.49 m/sec, those with Vmax of 2.50 to 2.99 m/sec (US cohort) or Vmax of 3.0 to 3.49 m/sec (Australian cohort) had a 1.5-fold increase in mortality risk within 10 years, adjusting for age, sex, presence of left heart disease, and left ventricular ejection fraction. Overall, the adjusted risk for mortality plateaued (1.75- to 2.25-fold increased risk) above a Vmax of 3.5 m/sec. This pattern of mortality persisted despite adjustment for a comprehensive list of comorbidities and treatments within the US cohort.

conclusionsWithin large, parallel patient cohorts managed in different health systems, similar patterns of mortality linked to increasingly severe AS were observed. These findings support ongoing clinical trials of aortic valve replacement in patients with nonsevere AS and suggest the need to develop and apply more proactive surveillance strategies in this high-risk population.

Indexed as

Aortic Valve StenosisVentricular Function, LeftAgedAged, 80 and overAortic ValveAustraliaCohort StudiesFemaleHumansMaleRetrospective StudiesSeverity of Illness IndexStroke VolumeAortic stenosisCohort studyEchocardiographyMortality

Identifiers

PMID36208655
PMCPMC9822866
OpenAlexW4302024721

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.