Guideline adherence and survival in aortic stenosis
Guideline adherence for serial evaluations in aortic stenosis is associated with increased survival rate and improved clinical outcomes, according to new research published in JAMA Cardiology. The findings support the need for close monitoring of patients with asymptomatic severe aortic stenosis and help to validate current guidelines for serial evaluations.
Current practice guidelines recommend exams every six to 12 months for patients with asymptomatic severe aortic stenosis and normal left ventricular function, yet the benefit of this close monitoring is unknown.
The new study, led by Mario Goessl, MD, PhD, of the Minneapolis Heart Institute Foundation, Minneapolis, examined the association of guideline adherence with clinical outcomes in 300 patients with asymptomatic severe aortic stenosis. Rates of survival and adverse clinical events, including heart attack, stroke, and heart failure hospitalization, were compared between patients who adhered to guidance on exams and those who did not. Among the requirements of an exam were a cardiopulmonary physical examination and echocardiogram. Guideline adherence was defined as an exam every 12 (±6) months until aortic valve replacement or death during the follow-up period (median, 4.5 years).
Dr. Goessl's team reported these key findings:
- Aortic valve replacement was performed more frequently (54 percent vs. 19 percent) and the median time for this performance was earlier (2.2 years vs. 3.5 years) in patients with guideline adherence.
- All-cause death was higher for nonadherent patients, and these patients also had a higher rate of hospital admission for heart failure decompensation in follow-up.
- Four-year survival that is free from death and heart failure hospitalisation was higher for adherent patients than for nonadherent patients (39 percent vs. 23 percent).
“To our knowledge, the present investigation is the first to demonstrate a survival benefit associated with adherence to guideline recommendations for serial clinical evaluations in patients with asymptomatic severe aortic stenosis. By helping to validate current guideline recommendations for closely monitoring patients with asymptomatic severe aortic stenosis, our findings support the efforts to improve guideline adherence, with the ultimate goal of improving clinical outcomes for these patients,” the research team said.
Source: JAMA Cardiology
Image Credit: Pixabay
Published on : Tue, 12 Sep 2017
Screening for atrial fibrillation by means of regularly performed self-measurements of cardiac rhythm using ECG is a stroke prevention measure recommended by renowned international experts. Heart rhythm disorders often occur only occasionally. That...
Automatic external defibrillator / with ECG monitor / public access FRED easyport SCHILLER
FRED easyport is an incredibly small and light pocket defibrillator, equipped with the effective and myocardium-saving defibrillation impulse called Multipulse Biowave. FRED easyport is the ideal companion for physicians, public service staff, even...
By lifting up the device cover, the FRED PA-1 starts up immediately and guides the rescuer step-by-step during the entire resuscitation process. The FRED PA-1 is available either as semi-automatic or fully automatic device.In its automatic version,...
The Connex® Spot Monitor features an easy-to-use, vivid touchscreen display and provides accurate vital signs measurement including blood pressure averaging, spot checking, interval monitoring and custom scoring across patient populations. The device...
Unbelievably small and light mechanical chest compression device In case of a sudden cardiac arrest, immediate chest compressions are required. Performing manual chest compressions well for an extended period of time is almost impossible. Thanks to...