title: Clinical Outcome of Patients with Aortic Stenosis and Coronary Artery Disease Not Treated According to Current Recommendations.
abstract: We evaluated the clinical outcome of patients with moderate/severe aortic stenosis and significant coronary disease not treated according to guidelines, recommending combined aortic valve replacement (AVR) and coronary artery bypass grafting (CABG). From 2002 to 2010, we assessed death up to 5 years in 650 patients with moderate/severe aortic stenosis and at least one coronary lesion (>50 %): 23 % were treated conservatively (MT), 17 % with percutaneous coronary intervention (PCI), 11 % with AVR, and 49 % with combined CABG and AVR. At a median follow-up of 58 months, overall death decreased over the groups (MT, 68 % vs. PCI, 44 % vs. AVR, 34 % vs. CABG and AVR, 23 %, p < 0.01). Compared to the MT group, Cox regression analysis adjusted for potential confounders showed significantly reduced mortality in the PCI, AVR, and CABG and AVR groups. When combined CABG and AVR is not feasible, PCI or AVR alone still improves significantly long-term survival as compared with MT alone.
authors.affiliation: Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan n. 164, B-9300, Aalst, Belgium.|Division of Cardiology, Department of Advanced Biomedical Science, University of Naples Federico II, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Gioia
authors.affiliation: Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan n. 164, B-9300, Aalst, Belgium.|Division of Cardiology, Department of Advanced Biomedical Science, University of Naples Federico II, Naples, Italy.
authors.forename: Mariano
authors.initials: M
authors.lastname: Pellicano
authors.affiliation: Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan n. 164, B-9300, Aalst, Belgium.|University Heart Center Graz, Graz, Austria.
authors.forename: Gabor G
authors.initials: GG
authors.lastname: Toth
authors.affiliation: Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan n. 164, B-9300, Aalst, Belgium.
authors.forename: Filip
authors.initials: F
authors.lastname: Casselman
authors.affiliation: Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan n. 164, B-9300, Aalst, Belgium.
authors.forename: Julien
authors.initials: J
authors.lastname: Adjedj
authors.affiliation: Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan n. 164, B-9300, Aalst, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Van Praet
authors.affiliation: Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan n. 164, B-9300, Aalst, Belgium.
authors.forename: Bernard
authors.initials: B
authors.lastname: Stockman
authors.affiliation: Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan n. 164, B-9300, Aalst, Belgium.
authors.forename: Ivan
authors.initials: I
authors.lastname: Degrieck
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Science, University of Naples Federico II, Naples, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.affiliation: Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan n. 164, B-9300, Aalst, Belgium.
authors.forename: William
authors.initials: W
authors.lastname: Wijns
authors.affiliation: Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan n. 164, B-9300, Aalst, Belgium.
authors.forename: Bernard
authors.initials: B
authors.lastname: De Bruyne
authors.affiliation: Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan n. 164, B-9300, Aalst, Belgium. emanuele.barbato@olvz-aalst.be.|Division of Cardiology, Department of Advanced Biomedical Science, University of Naples Federico II, Naples, Italy. emanuele.barbato@olvz-aalst.be.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Barbato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D019983:Guideline Adherence / Q000592:standards; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents
keywords: Aortic valve disease; Coronary artery disease; Coronary bypass grafts; Percutaneous coronary intervention