Table 2

Patient with unusual treatment decisions for whom decision was collected (171 missing patients)

Symptomatic patients* (n=1608)Asymptomatic patients (n=392)
Patients scheduled to undergo TAVR/SAVRPatients denied interventionP valuePatients without interventionPatients scheduled to undergo TAVR/SAVRP value
n=1225n=383n=238n=154
Proportion of patients (%)76.223.860.739.3
Age (years)77.7±9.479.8±9.9<0.00175.4±11.374.8±10.70.633
Female gender49.051.70.35339.140.90.717
BMI (kg/m2)27.6±5.227.1±5.80.11627.3±5.026.7±5.20.206
Comorbidity
Atrial fibrillation15.217.50.30110.113.20.368
 Previous cardiac surgery7.28.90.2755.92.60.127
 Diabetes on insulin8.89.10.8477.63.20.073
 PAPsys >55 mm Hg8.410.60.1984.25.50.562
 Chronic lung disease11.315.70.0263.85.20.514
 Haematological disorders4.112.6<0.0015.22.00.110
 Liver disease0.95.1<0.0014.31.30.137
 CrCl <50 mL/min25.937.0<0.00119.114.50.258
Frailty (severe)3.47.50.0014.42.60.366
Life expectancy <25%/2 years9.814.90.0192.74.80.493
Logistic EuroSCORE I (%)15.0±12.717.0±15.30.12810.9±10.012.5±9.70.359
EuroSCORE II (%)4.1±4.54.8±6.20.0471.9±1.72.2±2.60.243
Echocardiographic valve related parameters
 Aortic valve area indexed (cm2/m2)0.38±0.100.41±0.12<0.0010.44±0.110.40±0.100.001
 Maximum Jet velocity (m/s)4.33±0.674.22±0.680.0144.29±0.564.42±0.620.034
 Mean AV PG (mm Hg)48.0±14.644.6±15.4<0.00147.0±12.748.8±14.40.211
 AVA <1 cm2 and MPG <40 mm Hg (%)23.431.90.00120.317.10.429
 Aortic regurgitation (grade III/IV)7.07.60.6996.712.10.091
 Mitral regurgitation (grade III/IV)9.117.5<0.0018.53.90.081
 Mitral stenosis (grade III/IV)1.71.40.7622.12.41.000
 Tricuspid regurg. (grade III/IV)6.612.6<0.0015.94.00.428
 LVH (>12 mm thick)62.561.90.81757.958.90.849
 LV ESD (mm)33.0±11.329.9±9.2<0.00128.2±6.231.2±8.30.001
 LVEF <30%3.42.50.3630.92.80.211
 LVEF ≥50% and PAPsys <55 mm Hg67.970.00.47089.678.30.004
Indication for intervention in asymptomatic patients
 ≥1 class I or IIa indication (2017)14.127.50.007
 ≥ class I indication (2012)9.120.30.004
 LVEF <50%7.015.30.010
 Maximum Jet velocity >5.5 m/s1.84.20.194
 Pulm. hypertension >60 mm Hg2.32.11.000
Decision made for TAVR810/1608 (50.4)n.a.n.a.88/392 (22.4)
Decision made for SAVR15/1608 (25.8)n.a.n.a.65/392 (16.6)
  • *Defined as one or more of the following symptoms (presumed to be AS related): chest pain, shortness of breath, dizziness on exertion/syncope.

  • AV, aortic stenosis; AVA, aortic valve area; BMI, body mass index; ESD, end-systolic diameter; LVEF, left ventricular ejection fraction; LVH, left ventricular hypertrophy; MPG,mean pressure gradient; PAP, pulmonary artery pressure; PG, pressure gradient;SAVR, surgical aortic valve replacement; TAVR, transcatheter aortic valve replacement.