Abstract 14089: Significantly Worse Survival Despite Similar Rate of Progression of Aortic Stenosis in Patients With Radiation Heart Disease: A Matched Cohort Study
Introduction: Aortic stenosis (AS) patients with radiation associated cardiac disease (RACD) have worse outcomes when compared to a matched cohort with a similar degree of AS without RACD. We sought to assess whether this was due to more rapid progression of AS in RACD patients.
Methods: We included 81 RACD patients with at least moderate AS who had ≥ 2 surface echocardiograms at least 1 year apart and matched them in a 1:2 fashion based on age, gender and aortic valve area (AVA) with 162 patients without RACD. Serial AV gradients (AVG) and AVA were recorded. AV replacement (AVR) and mortality during follow-up were recorded.
Results: Relevant characteristics of the two groups are shown in Figure 1. 100% of patients had one; 71% had two; and 39% of patients had three follow-up echocardiograms. Prior to AVR, over the course of follow-up echoes, peak and mean AVG and AVA were not significantly different between the RACD patients and the control patients (Figure 2a). At 6.6±4 years of follow-up, 60% underwent AVR (of which 42% were isolated surgical & 16% were transcatheter AVR) and 19% died (Figure 1). Kaplan-Meier curves of RACD compared with non-RACD group are shown in Figure 2b.
Conclusion: Prior to AVR, AS patients with RACD have an AVG and AVA rate of progression similar to matched non-RACD patients. Despite an earlier time to AVR in RACD patients, their long-term survival is significantly worse compared with the non RACD group. Other comorbidities likely account for the higher rate of adverse outcomes in RACD patients. .
Author Disclosures: E. Donnellan: None. B.P. Griffin: None. D.R. Johnston: None. Z.B. Popovic: None. S.R. Kapadia: None. A. Krishnaswamy: None. J.F. Sabik: None. S. Mick: None. L.G. Svensson: None. M.Y. Desai: None.
- © 2016 by American Heart Association, Inc.