Malignant disease as a comorbidity in patients with severe aortic stenosis: clinical presentation, outcomes, and management.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Minamino-Muta Eri, Kato Takao, Morimoto Takeshi, Taniguchi Tomohiko, Nakatsuma Kenji, Kimura Yuki, Inoko Moriaki, Shirai Shinichi, Kanamori Norio, Murata Koichiro, Kitai Takeshi, Kawase Yuichi, Miyake Makoto, Izumi Chisato, Mitsuoka Hirokazu, Hirano Yutaka, Sasa Tomoki, Nagao Kazuya, Inada Tsukasa, Nishikawa Ryusuke, Takeuchi Yasuyo, Yamagami Shintaro, Yamane Keiichiro, Su Kanae, Komasa Akihiro, Ishii Katsuhisa, Yamashita Yugo, Kato Yoshihiro, Takabayashi Kensuke, Saito Naritatsu, Minatoya Kenji, Kimura Takeshi, CURRENT AS registry Investigators
Аннотация
METHODS AND RESULTS: Using data of 3815 patients with severe AS in a retrospective multicentre registry [CURRENT AS (Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis) registry], we compared 3-year clinical outcomes among three groups based on malignancy status: with malignancy currently under treatment including best supportive care (malignancy group), with a history of malignancy without any current treatment (past history group), or without history of malignancy (no malignancy group). Patients in the malignancy group (n = 124) were more often men and had higher prevalence of low body mass index, recurrence of malignancy, anaemia, and asymptomatic status, despite comparable surgical risks and echocardiographic parameters. The malignancy group or the past history group (n = 389) had significantly higher risk for all-cause death [hazard ratio (HR) 2.49, 95% CI (95% confidence interval) 1.98-3.14; HR 1.23, 95% CI 1.04-1.46] and for malignancy-related death (HR 16.2, 95% CI 10.64-24.54; HR 3.66, 95% CI 2.43-5.52) than that of the no malignancy group (n = 3302). The excess risk for aortic valve-related death was not observed in the malignancy group (HR 0.79, 95% CI 0.48-1.29) and was lower in the past history group (HR 0.72, 95% CI 0.53-0.96). In the malignancy group, the treatment strategy (surgery: n = 16, conservative management: n = 108) was determined based on the clinical status of AS or life expectancy.
CONCLUSIONS: Malignancy had marked effect on all-cause death and malignancy-related death in patients with severe AS. History of malignancy also had a smaller but significant effect on mortality.