Cited 276 times in
Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis
DC Field | Value | Language |
---|---|---|
dc.contributor.author | 홍그루 | - |
dc.date.accessioned | 2020-02-26T06:41:21Z | - |
dc.date.available | 2020-02-26T06:41:21Z | - |
dc.date.issued | 2020 | - |
dc.identifier.issn | 0028-4793 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/175251 | - |
dc.description.abstract | BACKGROUND: The timing and indications for surgical intervention in asymptomatic patients with severe aortic stenosis remain controversial. METHODS: In a multicenter trial, we randomly assigned 145 asymptomatic patients with very severe aortic stenosis (defined as an aortic-valve area of ≤0.75 cm2 with either an aortic jet velocity of ≥4.5 m per second or a mean transaortic gradient of ≥50 mm Hg) to early surgery or to conservative care according to the recommendations of current guidelines. The primary end point was a composite of death during or within 30 days after surgery (often called operative mortality) or death from cardiovascular causes during the entire follow-up period. The major secondary end point was death from any cause during follow-up. RESULTS: In the early-surgery group, 69 of 73 patients (95%) underwent surgery within 2 months after randomization, and there was no operative mortality. In an intention-to-treat analysis, a primary end-point event occurred in 1 patient in the early-surgery group (1%) and in 11 of 72 patients in the conservative-care group (15%) (hazard ratio, 0.09; 95% confidence interval [CI], 0.01 to 0.67; P = 0.003). Death from any cause occurred in 5 patients in the early-surgery group (7%) and in 15 patients in the conservative-care group (21%) (hazard ratio, 0.33; 95% CI, 0.12 to 0.90). In the conservative-care group, the cumulative incidence of sudden death was 4% at 4 years and 14% at 8 years. CONCLUSIONS: Among asymptomatic patients with very severe aortic stenosis, the incidence of the composite of operative mortality or death from cardiovascular causes during the follow-up period was significantly lower among those who underwent early aortic-valve replacement surgery than among those who received conservative care. (Funded by the Korean Institute of Medicine; RECOVERY ClinicalTrials.gov number, NCT01161732.). | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Massachusetts Medical Society | - |
dc.relation.isPartOf | NEW ENGLAND JOURNAL OF MEDICINE | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | Aortic Valve/surgery* | - |
dc.subject.MESH | Aortic Valve Stenosis/mortality | - |
dc.subject.MESH | Aortic Valve Stenosis/surgery* | - |
dc.subject.MESH | Aortic Valve Stenosis/therapy | - |
dc.subject.MESH | Asymptomatic Diseases/therapy | - |
dc.subject.MESH | Cardiovascular Diseases/mortality | - |
dc.subject.MESH | Conservative Treatment* | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Follow-Up Studies | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Incidence | - |
dc.subject.MESH | Kaplan-Meier Estimate | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Patient Acuity | - |
dc.subject.MESH | Postoperative Complications/mortality | - |
dc.title | Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Duk-Hyun Kang | - |
dc.contributor.googleauthor | Sung-Ji Park | - |
dc.contributor.googleauthor | Seung-Ah Lee | - |
dc.contributor.googleauthor | Sahmin Lee | - |
dc.contributor.googleauthor | Dae-Hee Kim | - |
dc.contributor.googleauthor | Hyung-Kwan Kim | - |
dc.contributor.googleauthor | Sung-Cheol Yun | - |
dc.contributor.googleauthor | Geu-Ru Hong | - |
dc.contributor.googleauthor | Jong-Min Song | - |
dc.contributor.googleauthor | Cheol-Hyun Chung | - |
dc.contributor.googleauthor | Jae-Kwan Song | - |
dc.contributor.googleauthor | Jae-Won Lee | - |
dc.contributor.googleauthor | Seung-Woo Park | - |
dc.identifier.doi | 10.1056/NEJMoa1912846 | - |
dc.contributor.localId | A04386 | - |
dc.relation.journalcode | J02371 | - |
dc.identifier.eissn | 1533-4406 | - |
dc.identifier.pmid | 31733181 | - |
dc.identifier.url | https://www.nejm.org/doi/full/10.1056/NEJMoa1912846 | - |
dc.contributor.alternativeName | Hong, Geu Ru | - |
dc.contributor.affiliatedAuthor | 홍그루 | - |
dc.citation.volume | 382 | - |
dc.citation.number | 2 | - |
dc.citation.startPage | 111 | - |
dc.citation.endPage | 119 | - |
dc.identifier.bibliographicCitation | NEW ENGLAND JOURNAL OF MEDICINE, Vol.382(2) : 111-119, 2020 | - |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.