TY - JOUR 
A1 - Gómez Doblas, J. J.
AU - López-Garrido, Miguel Antonio
AU - Becerra Muñoz, Víctor Manuel
AU - Orellana Figueroa, Hugo Nelson
AU - Carro Hevia, Amelia
AU - García de la Villa, Bernardo
AU - Cornide, L.
AU - Martínez Sellés Oliveria Soares, Manuel
T1 - Significant mitral regurgitation worsens the prognosis and favors the decision of conservative treatment in octogenarians with severe symptomatic aortic stenosis
Y1 - 2018
SN - 0953-6205
UR - http://hdl.handle.net/11268/7372
AB - Introduction:
The coexistence of significant mitral regurgitation (MR) and severe aortic stenosis is prevalent, has a prognostic impact and makes treatment in the elderly population a complex issue. The aim of this study is to determine the prevalence of significant MR among a population of octogenarians and its influence on treatment and prognosis.

Methods:
We used the data from PEGASO (Pronóstico de la Estenosis Grave Aórtica Sintomática del Octogenario), a prospective registry that consecutively included 928 patients aged ≥80 years with severe symptomatic aortic stenosis.

Results:
The prevalence of significant MR was 8.5% (79 patients) and independently associated with the decision to treat conservatively (odds ratio = 2.28, 95% confidence interval: 1.31–3.95, p = 0.003). The group of patients with significant MR had higher overall mortality at 12 months follow-up (51.9% vs 25%, p < 0.001), which remained on division into subgroups based on the presence of comorbidities (Charlson<5: 49.2% vs 21.9%, p < 0.001; and Charlson ≥5: 62.5% vs 41.7%, p = 0.07). Within the group of patients in whom conservative treatment was performed, those with significant MR had higher mortality at one year (62.7% vs 35%, p < 0.001). MR was a significant independent predictor of overall mortality at 12-month follow-up (hazard ratio = 1.87, 95% confidence interval: 1.09–3.18, p = 0.022).

Conclusions:
Significant MR has a high prevalence and worsens the prognosis of octogenarian patients with severe symptomatic aortic stenosis, especially in patients with conservative treatment, independently of the existence of comorbidities.
KW - Estenosis aórtica
KW - Ancianos
KW - Enfermedad cardiovascular
KW - Anciano
LA - eng
ER -