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Titolo:
Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly
Autore:
Otto, CM; Lind, BK; Kitzman, DW; Gersh, BJ; Siscovick, DS;
Indirizzi:
Univ Washington, Dept Med, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 ton, Dept Med, Seattle, WA 98195 USA Univ Washington, Dept Biostat, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 Dept Biostat, Seattle, WA 98195 USA Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 ept Epidemiol, Seattle, WA 98195 USA Univ Washington, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 Hlth Res Unit, Seattle, WA 98195 USA Wake Forest Univ, Sch Med, Div Cardiol, Winston Salem, NC USA Wake Forest Univ Winston Salem NC USA Div Cardiol, Winston Salem, NC USA Mayo Clin, Div Cardiol, Rochester, MN USA Mayo Clin Rochester MN USAMayo Clin, Div Cardiol, Rochester, MN USA
Titolo Testata:
NEW ENGLAND JOURNAL OF MEDICINE
fascicolo: 3, volume: 341, anno: 1999,
pagine: 142 - 147
SICI:
0028-4793(19990715)341:3<142:AOASWC>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
NORMAL CORONARY-ARTERIES; DOPPLER-ECHOCARDIOGRAPHY; NATURAL-HISTORY; ANGINA-PECTORIS; EARLY LESION; STENOSIS; PROGRESSION; ADULTS; DISEASE; EXPRESSION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Otto, CM Univ Washington, Div Cardiol, Box 356422, Seattle, WA 98195 USA Univ Washington Box 356422 Seattle WA USA 98195 tle, WA 98195 USA
Citazione:
C.M. Otto et al., "Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly", N ENG J MED, 341(3), 1999, pp. 142-147

Abstract

Background Although aortic-valve stenosis is clearly associated with adverse cardiovascular outcomes, it is unclear whether valve sclerosis increasesthe risk of cardiovascular events. Methods We assessed echocardiograms obtained at base line from 5621 men and women 65 years of age or older who were enrolled in a population-based prospective study, On echocardiography, the aortic valve was normal in 70 percent (3919 subjects), sclerotic without outflow obstruction in 29 percent (1610), and stenotic in 2 percent (92), The subjects were followed for a mean of 5.0 years to assess the risk of death from any cause and of death fromcardiovascular causes. Cardiovascular morbidity was defined as new episodes of myocardial infarction, angina pectoris, congestive heart failure, or stroke. Results There was a stepwise increase in deaths from any cause (P for trend, <0.001) and deaths from cardiovascular causes (P for trend, <0.001) withincreasing aortic-valve abnormality; the respective rates were 14.9 and 6.1 percent in the group with normal aortic valves, 21.9 and 10.1 percent in the group with aortic sclerosis, and 41.3 and 19.6 percent in the group with aortic stenosis, The relative risk of death from cardiovascular causes among subjects without coronary heart disease at base line was 1.66 (95 percent confidence interval, 1.23 to 2.23) for those with sclerotic valves as compared with those with normal valves, after adjustment for age and sex. Therelative risk remained elevated after further adjustment for clinical factors associated with sclerosis (relative risk, 1.52; 95 percent confidence interval, 1.12 to 2.05), The relative risk of myocardial infarction was 1.40(95 percent confidence interval, 1.07 to 1.83) among subjects with aortic sclerosis, as compared with those with normal aortic valves. Conclusions Aortic sclerosis is common in the elderly and is associated with an increase of approximately 50 percent in the risk of death from cardiovascular causes and the risk of myocardial infarction, even in the absence of hemodynamically significant obstruction of left ventricular outflow. (N Engl J Med 1999;341:142-7) (C) 1999, Massachusetts Medical Society.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/11/20 alle ore 08:29:32