Abstract 13621: Clinical Outcomes in Patients With Severe Aortic Stenosis and End-stage Renal Disease
Background: Although patients with end-stage renal disease (ESRD) have a high cardiovascular mortality, clinical outcomes of the conservatively or surgically managed aortic stenosis (AS) patients with ESRD are unknown.
Purpose: The aim of this study was to investigate long-term outcomes of the severe AS patients with ESRD.
Methods: One hundred consecutive patients with severe AS (aortic valve peak jet velocity of ≥ 4.0 m/s or mean aortic pressure gradient ≥ 40 mmHg) were studied. Cardiovascular events (death, congestive heart failure, acute myocardial infarction, infective endocarditis or aortic valve replacement) after initial conservative strategy or early surgery were compared between patients with (ESRD group: n=17) and without (CTL group: n=83) ESRD.
Results: During follow-up (median 3.9 years), Overall survival as well as cardiovascular event-free survival were significantly lower in ESRD group than in CTL group. In CTL group, early surgery was associated with better long-term survival as compared with initial conservative strategy (Log-rank, p<0.01). On the other hand, no significant difference in survival was observed between early surgery and initial conservative strategy in ESRD group (Log-rank, p=0.82) (Figure).
Conclusions: Clinical outcomes of patients with severe AS and ESRD were poor irrespective of the initial treatment strategy. Efficacy of transcatheter aortic valve replacement on prognosis of the AS patients with ESRD needs further investigation.
- © 2013 by American Heart Association, Inc.