Abstract 12940: Prognosis of Hemodialysis Patients With Severe Aortic Stenosis: Findings From the Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis (CURRENT AS) Registry
Background: Prognosis of hemodialysis (HD) patients with severe aortic stenosis (AS) remains unclear.
Methods and Results: The CURRENT AS registry, a Japanese multicenter registry enrolled 3815 consecutive patients with severe AS. There were 1197 patients treated with the initial aortic valve replacement (AVR) strategy including surgical AVR and transcatheter aortic valve implantation and 2617 patients treated with the conservative strategy. The median follow-up duration after the index echocardiography was 1361 days, with a 90% follow-up at 2-year. HD patients accounted for 11% (405/3815 patients). The cumulative 5-year incidence of all-cause death (primary outcome measure) was significantly higher in HD patients than in non-HD patients in both the entire cohort and the initial AVR group (see Figure). Among HD patients, the initial AVR group as compared with the conservative group was associated with significantly lower cumulative 5-year incedences of all-cause death (see Figure) and sudden death (10.2% versus 31.7%, P<0.001). Operative mortality rate at 30-day after AVR in HD patients was as high as 7.7% (10/131 patients).
Conclusions: Being on HD indicates a grimmer prognosis in patients with severe AS, even when treated with the initial AVR strategy. The initial AVR strategy in HD patients was associated with high operative mortality risk, while it was associated with lower risk of death in long-term.
Author Disclosures: Y. Kawase: None. K. Kadota: None. T. Taniguchi: None. T. Morimoto: None. K. Iwasaki: None. A. Kuwayama: None. K. Miura: None. M. Ohya: None. T. Shimada: None. H. Amano: None. Y. Fuku: None. T. Maruo: None. T. Kimura: None.
- © 2016 by American Heart Association, Inc.