title: Significance of Coronary Artery Disease and Left Ventricular Afterload in Unoperated Asymptomatic Aortic Stenosis.
abstract: BACKGROUND
  Because the covariates of cardiovascular events in unoperated patients with asymptomatic aortic stenosis (AS) have not been adequately evaluated, we aimed to identify them.
  
  
  RESULTS
  A total of 230 patients with asymptomatic severe AS were retrospectively enrolled. The patients were divided into 2 groups based on aortic valve replacement (AVR) after enrollment: a non-AVR group (n=112), and an AVR group (n=118). The primary clinical endpoint was cardiovascular events, which were defined as cardiovascular death or hospitalization. Coronary artery disease [hazard ratio (HR): 3.62, 95% confidence interval (CI): 1.585-8.245, P<0.01] and high valvulo-arterial impedance (HR: 3.08, 95% CI: 1.261-7.532, P<0.05) were identified as independent covariates of cardiovascular events in the non-AVR group. The relative risk of cardiovascular events rose with an increase in the number of risk factors (P<0.0001).
  
  
  CONCLUSIONS
  In unoperated patients with asymptomatic AS, the presence of coronary artery disease and increased global left ventricular afterload may be associated with a poor prognosis.
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Shibayama
authors.forename: Masao
authors.initials: M
authors.lastname: Daimon
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kawata
authors.forename: Sakiko
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Ryoko
authors.initials: R
authors.lastname: Morimoto-Ichikawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Maruyama
authors.forename: Shuo-Ju
authors.initials: SJ
authors.lastname: Chiang
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000401:mortality; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors