title: Risk score for predicting outcome in patients with asymptomatic aortic stenosis.
abstract: BACKGROUND
  The management of patients with asymptomatic severe aortic stenosis remains controversial. We sought to develop a continuous risk score for predicting the midterm development of symptoms or adverse events in this setting.
  
  
  RESULTS
  We prospectively followed 107 patients with asymptomatic aortic stenosis (aged 72 years [63 to 77]; 35 women; aortic-jet velocity, 4.1 m/s [3.5 to 4.4]) at a single center in France. Predefined end points for assessing outcome were the occurrence within 24 months of death or aortic valve replacement necessitated by symptoms or by a positive exercise test. Variables independently associated with outcome were used to build a score that was validated in an independent cohort of 107 patients from Belgium. Independent predictors of outcome were female sex, peak aortic-jet velocity, and B-type natriuretic peptide at baseline. Accordingly, the score could be calculated as follows: Score=[peak velocity (m/s) x 2]+(natural logarithm of B-type natriuretic peptide x 1.5)+1.5 (if female sex). Event-free survival after 20 months was 80% for patients within the first score quartile compared with only 7% for the fourth quartile. Areas under the receiver operating characteristic curve for the score were 0.90 and 0.89 in the development and validation cohorts, respectively.
  
  
  CONCLUSIONS
  If further validation is achieved, this score may be useful to predict outcome in individual patients with asymptomatic aortic stenosis to select those who might benefit from early surgery.
authors: Department of Cardiology, Henri Mondor Hospital, 51 avenue De Lattre de Tassigny, 94010 Créteil, France. jean-luc.monin@hmn.aphp.fr
authors: Jean-Luc
authors: JL
authors: Monin
authors: Patrizio
authors: P
authors: Lancellotti
authors: Mehran
authors: M
authors: Monchi
authors: Pascal
authors: P
authors: Lim
authors: Emmanuel
authors: E
authors: Weiss
authors: Luc
authors: L
authors: Piérard
authors: Pascal
authors: P
authors: Guéret
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000601:surgery; D015150:Echocardiography, Doppler; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods / Q000592:standards; D012307:Risk Factors; D012720:Severity of Illness Index