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A. Basics
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01. History of Cardiology
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04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
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28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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Clinical Predictors of Mortality in Moderate to Severe Aortic Stenosis: A Cohort of Cardiology Outpatients
Session:
Sessão de Posters 04 - Prognóstico e desfechos clínicos na estenose aórtica
Speaker:
António Afonso Angélico Gonçalves
Congress:
CPC 2026
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.2 Valvular Heart Disease – Epidemiology, Prognosis, Outcome
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
António Afonso Angélico Gonçalves; Inês Arrobas Rodrigues; Marta Almeida; André Lobo; Marta Leite; Inês Neves; Francisco Sousa; Leonor Moura; Francisca Nunes; Rafael Teixeira; Ricardo Fontes Carvalho
Abstract
<p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Introduction</strong><br /> Aortic stenosis (AS) is highly prevalent and is associated with substantial morbidity and mortality. Current treatment relies on surgical or percutaneous aortic valve replacement. However, acessibility remains a public health challenge. Identifying risk factors of adverse outcomes may help patient management.</span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Aim</strong><br /> To identify baseline clinical parameters that best predict mortality in a cohort of outpatients with moderate to severe AS.</span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Methods</strong><br /> We retrospectively identified patients with a first diagnosis of moderate to severe AS and preserved left ventricular ejection fraction who presented in the cardiology outpatient clinic between 2012 and 2020. Patients were followed until August 2025. A multivariate stepwise logistic regression was used to identify predictors of mortality. The analysis was repeated for the subgroup aged <75 years.</span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Results</strong><br /> A total of 914 patients were included (mean age 75.6 ± 8.8 years; 48.3% male; 88.0% with hypertension; 38.4% with diabetes; 15.9% smokers; 74.0% with dyslipidemia). Over a mean follow-up of 5.0 ± 3.4 years, 483 patients (52.8%) died. Independent predictors of higher mortality were age (Odds Ratio [OR] 1.11, 95% Confidence Interval [CI] 1.08–1.13, p<0.001), diabetes (OR 1.79, 95% CI 1.30–2.48, p<0.001), atrial fibrillation/flutter (OR 1.72, 95% CI 1.22–2.42, p=0.002), and prior stroke (OR 1.95, 95% CI 1.22–3.10). Estimated glomerular filtration rate (eGFR) was inversely associated with mortality (OR −0.007, 95% CI −0.012 to −0.001, p=0.026).<br /> In patients <75 years, only prior stroke (OR 3.25, 95% CI 1.62–6.25, p=0.001) and diabetes (OR 2.19, 95% CI 1.37–3.49, p=0.001) remained significant positive predictors, whereas eGFR had a negative association with mortality (OR 0.990, 95% CI 0.984–0.998, p=0.012).</span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion</strong><br /> Outpatients with moderate to severe AS have a high short-term mortality. Older age, diabetes, renal dysfunction, and a history of stroke or atrial fibrillation are associeted with increase risk. Closer clinical surveillance and timely intervention may help reduce mortality in this population.</span></span></p>
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