Journal of Geriatric Cardiology最新文献

{"title":"The impact of cerebral small vessel disease burden on prognosis in patients with acute coronary syndrome.","authors":"Xiao-Jun Ding, Yu Zhao, Ze-Ya Li, Yong-Bo Zhang, An-Qi Yang, Yi He, Rong-Chong Huang","doi":"10.26599/1671-5411.2024.10.003","DOIUrl":"https://doi.org/10.26599/1671-5411.2024.10.003","url":null,"abstract":"<p><strong>Background: </strong>Acute coronary syndrome (ACS) presents with a variable prognosis, posing significant public health challenges. This study investigated the potential link between cerebral small vessel disease (CSVD) burden and outcomes in patients with ACS.</p><p><strong>Methods: </strong>In this retrospective cohort study, ACS patients admitted to Beijing Friendship Hospital, Capital Medical University, Beijing, China from January 2020 to October 2021, were analyzed. CSVD burden was assessed using magnetic resonance imaging markers, including white matter lesions, lacunar infarcts, cerebral microbleeds, and enlarged perivascular spaces. The correlation between CSVD burden and clinical outcomes, including major adverse cardiovascular and cerebrovascular events, myocardial infarction (MI), target vessel revascularization, stroke, and mortality was examined over a one-year follow-up.</p><p><strong>Results: </strong>Out of 248 patients, 216 patients were categorized into the low score group (LSG-CSVD) and 32 patients were categorized into the high score group (HSG-CSVD). Patients in the HSG-CSVD group exhibited significantly worse prognosis, with an elevated risk of major adverse cardiovascular and cerebrovascular events, MI, and target vessel revascularization. After adjusting for age, sex, hypertension, troponin T, and estimated glomerular filtration rate, a significantly higher risk of MI was observed in the HSG-CSVD group (HR = 4.51, 95% CI: 1.53-13.26, <i>P</i> = 0.006). Subgroup analysis by age and sex consistently demonstrated increased adverse outcomes in the HSG-CSVD.</p><p><strong>Conclusions: </strong>The study highlights a direct association between increased CSVD burden and poorer ACS outcomes, particularly in MI risk. These findings underscore the importance of considering CSVD burden as a crucial prognostic factor in ACS management, facilitating risk stratification and guiding personalized treatment strategies.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 10","pages":"972-980"},"PeriodicalIF":1.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic disease and peripheral artery disease.","authors":"Sheng-Shou Hu","doi":"10.26599/1671-5411.2024.10.008","DOIUrl":"https://doi.org/10.26599/1671-5411.2024.10.008","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of car-diovascular health in China. In connection with the previous section, this 10&lt;sup&gt;th&lt;/sup&gt; section of the report offers a comprehensive analysis of aortic disease and peripheral artery disease. Aortic dissection is a critical disease, with a higher incidence in men than in women. The main risk factors include hypertension, gene mutations, and so on. Recent studies suggest that young patients with aortic dissection have a higher body mass index, and there is a significant correlation between low ambient temperature and sudden temperature drop and the onset of dissection. The main hazards are aortic rupture or poor branch perfusion, which is life threatening. According to the lesion location, it is divided into Stanford A type (involving the ascending aorta) and Stanford B type (not involving the ascending aorta). The treatment of type A dissection is mainly open surgery, while the treatment of type B dissection is preferably endovascular treatment. In recent years, with the continuous development of endovascular technique, the treatment of aortic arch lesions has transformed gradually from open to hybrid, and then to total endovascular treatment. The prevalence of abdominal aortic aneurysm is relatively low (&lt; 1%), and its risk factors mainly include smoking, hypertension, dyslipidemia, etc. The main hazard is the rupture of the aneurysm leading to death. Currently, treatment methods include endovascular repair and open surgery. According to data from Hospital Quality Monitoring System (HQMS), in the past five years, the number of open and endovascular operations for aortic disease in China has shown an upward trend, which may be due to the popularization of diagnostic and therapeutic techniques and increased attention to aortic disease. The in-hospital mortality rates of thoracic endovascular aortic repair, endovascular aortic repair, and Bentall operations are relatively low (all &lt; 2%). Due to the complexity and difficulty of the operation, the in-hospital mortality of total arch replacement is 5.9%-7.4%. Overall, the in-hospital mortality decreased while the number of surgeries increased. This section also elaborates on the five peripheral artery diseases (PADs): lower extremity artery disease (LEAD), carotid atherosclerotic disease, subclavian artery stenosis, mesenteric artery disease and renal artery stenosis, from the perspectives of epidemiology, risk factors, evaluation methods, diagnosis, and treatment. PAD is common among middle-aged and elderly people, and is significantly related to the risk factors of cardiovascular disease. Diagnosis and treatment methods are constantly being improved and updated. Besides traditional evaluation methods, artificial intelligence, molecular biology and other methods have been continuously developed, improving diagnostic sensitivity and specificity. Treatment methods include risk factor control, medication,","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 10","pages":"931-943"},"PeriodicalIF":1.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravascular lithotripsy successfully open recurrent in-stent chronic occlusion lesion combined with circular calcification.","authors":"Yu Zhao, Xue-Qing Dong, Jun-Jie Li, Ji Qiu, Jia-Hui Liu, Hui-Juan Li, Ying Liu, Meng-Ying Wang, Hai-Yan Wang, Wen-Hui Fan, Yuan-Yang Jia, Jing Bai","doi":"10.26599/1671-5411.2024.10.004","DOIUrl":"https://doi.org/10.26599/1671-5411.2024.10.004","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 10","pages":"997-1002"},"PeriodicalIF":1.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic inflammatory index as a predictive marker for the severity of coronary artery disease in individuals with chronic kidney disease.","authors":"Meng-Qi Zhao, Yang Zhang, Xin Huang, Jian-Jun Peng","doi":"10.26599/1671-5411.2024.10.002","DOIUrl":"https://doi.org/10.26599/1671-5411.2024.10.002","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the correlation between the inflammatory intensity, as indicated by the systemic inflammatory index (SII), and the severity of coronary artery disease (CAD) in patients with chronic kidney disease (CKD).</p><p><strong>Methods: </strong>A total of 280 CKD patients who underwent coronary angiography were enrolled. CAD was evaluated using the Gensini score (GS). Patients were divided into the low, medium and high SII groups according to the tertiles of the SII values. Logistic regression analysis was conducted to analyze the relationship between SII and GS. The cutoff points for the sensitivity and specificity of SII in predicting GS were estimated by performing the receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>Patients in the higher SII group had a higher prevalence of CAD (<i>P</i> = 0.013). In addition, the high SII group had more patients with complex CAD (triple-vessel disease and/or left main coronary artery stenosis) and chronic total occlusion lesions, and more patients required revascularization (<i>P</i> < 0.05). Correlation analysis suggested a positive relationship between SII and GS, and in comparison to neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, SII displayed a stronger correlation with GS (<i>r</i> = 0.332, <i>P</i> < 0.001). Multifactorial logistic regression analysis revealed that SII is independently associated with the severity of CAD (adjusted OR = 1.14, 95% CI: 1.08-1.21, <i>P</i> < 0.01), particularly among elderly patients (age ≥ 65 years). Receiver operating characteristic curve analysis indicated that the optimal cutoff value for SII in predicting severe coronary artery stenosis (GS > 60) was 6.01 (sensitivity: 76.30%, specificity: 53.50%), with an area under the curve (AUC) of 0.705 (95% CI: 0.642-0.768, <i>P</i> < 0.001), which was statistically significantly better than platelet-to-lymphocyte ratio (AUC = 0.646, 95% CI: 0.579-0.713, <i>P</i> < 0.001) and neutrophil-to-lymphocyte ratio (AUC = 0.643, 95% CI: 0.574-0.712, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>In patients with CKD, SII is independently associated with the severity of CAD, especially in individuals aged 65 years or older. Furthermore, SII functions as a predictive marker for the severity of coronary lesions.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 10","pages":"962-971"},"PeriodicalIF":1.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of multimodality imaging in calcified valves with infective endocarditis.","authors":"Aker Amir, Alexander Fuks, Salim Adawi, Yuval Avidan, Vsevolod Tabachnikov, Amnon Eitan, Avinoam Shiran","doi":"10.26599/1671-5411.2024.09.006","DOIUrl":"10.26599/1671-5411.2024.09.006","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 9","pages":"927-930"},"PeriodicalIF":1.8,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal effect of psoriasis on aortic valve stenosis: a two-sample Mendelian randomization study.","authors":"Ke-Xin Jiang, Yan Wang, Yu-Tong Liu, Yanjiani Xu, Fang-Yang Huang, Mao Chen","doi":"10.26599/1671-5411.2024.09.002","DOIUrl":"10.26599/1671-5411.2024.09.002","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological studies have suggested a potential connection between psoriasis and an increased risk of aortic valve stenosis (AS), though the impact of psoriasis on AS progression remains uncertain. The study aims to investigate the causal relationship between psoriasis and AS using Mendelian randomization (MR) analysis, as well as to uncover potential mechanisms underlying this association.</p><p><strong>Methods: </strong>A two-sample MR analysis was conducted using publicly available summary statistics from genome-wide association studies (GWAS) of psoriasis and AS. Cis-eQTL and significant genes were identified for each causal single-nucleotide polymorphisms (SNPs), followed by pathway enrichment and protein-protein interaction (PPI) analysis for functional evaluation. Hub genes were pinpointed by Cytospace. The transcriptional profile of AS population was acquired, and interconnected genes networks were clustered using Molecular Complex Detection (MCODE).</p><p><strong>Results: </strong>Our results demonstrate a significant causal relationship between psoriasis and AS, with a genetic predisposition to psoriasis associated with a higher AS risk (odds ratio: 1.46). Pathway and PPI analyses unveiled 15 hub genes, including HLA-C, HLA-B, ISG15, IFIT3, and MX2, along with immune-related pathways linking psoriasis and AS. Moreover, the transcriptional profiling of the AS database highlighted the significant involvement of adaptive immune cells in AS development. Notably, among the 15 hub genes, ISG15, MX2, OAS3, OASL, IFI6, and EPSTI1 exhibited higher expression in the AS population.</p><p><strong>Conclusion: </strong>Our study provides compelling evidence supporting a causal relationship between psoriasis and AS. Furthermore, the identified hub genes and immune-related pathways may play an important role in the development of both diseases.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 9","pages":"865-873"},"PeriodicalIF":1.8,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a 6-gene signature derived from RNA modification-associated genes for the diagnosis of Acute Stanford Type A Aortic Dissection.","authors":"Ting-Ting Zhang, Qun-Gen Li, Zi-Peng Li, Wei Chen, Chang Liu, Hai Tian, Jun-Bo Chuai","doi":"10.26599/1671-5411.2024.09.007","DOIUrl":"10.26599/1671-5411.2024.09.007","url":null,"abstract":"<p><strong>Background: </strong>Acute Stanford Type A Aortic Dissection (ATAAD) is a critical medical emergency characterized by significant morbidity and mortality. This study aims to identify specific gene expression patterns and RNA modification associated with ATAAD.</p><p><strong>Methods: </strong>The GSE153434 dataset was obtained from the Gene Expression Omnibus (GEO) database. Differential expression analysis was conducted to identify differential expression genes (DEGs) associated with ATAAD. To validate the involvement of RNA modification in ATAAD, RNA modification-related genes (M6A, M1A, M5C, APA, A-to-I) were acquired from GeneCards, following by Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis. A gene prediction signature consisting of key genes was established, and Real-time PCR was used to validate the gene expression in clinical samples. The patients were then divided into high and low-risk groups, and subsequent enrichment analysis, including Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Set Enrichment Analysis (GSEA), Gene Set Variation Analysis (GSVA), and assessments of immune infiltration. A co-expression network analysis (WGCNA) was performed to explore gene-phenotype relationships and identify key genes.</p><p><strong>Results: </strong>A total of 45 RNA modification genes were acquired. Six gene signatures (YTHDC1, WTAP, CFI, ADARB1, ADARB2, TET3) were developed for ATAAD diagnosis and risk stratification. Enrichment analysis suggested the potential involvement of inflammation and extracellular matrix pathways in the progression of ATAAD. The incorporation of pertinent genes from the GSE147026 dataset into the six-gene signature further validated the model's effectiveness. A significant upregulation in WTAP, ADARB2, and TET3 expression, whereas YTHDC1 exhibited a noteworthy downregulation in the ATAAD group.</p><p><strong>Conclusion: </strong>Six-gene signature could serve as an efficient model for predicting the diagnosis of ATAAD.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 9","pages":"884-898"},"PeriodicalIF":1.8,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental disorders after myocardial infarction: potential mediator role for chemokines in heart-brain interaction?","authors":"Parth Patel, Feiyan Yang, Dumitru A Iacobas, Lei Xi","doi":"10.26599/1671-5411.2024.09.004","DOIUrl":"10.26599/1671-5411.2024.09.004","url":null,"abstract":"<p><p>Acute myocardial infarction (MI) remains one of the leading causes of mortality and morbidity in the global communities. A prevailing topic that has attracted increasing attentions over the past few decades is the so-called heart-brain interaction, in particular following a major traumatic event such as MI. Increased prevalence of depression and other mental disorders has been recognized in cardiac patients after MI, coronary catheterization, or cardiothoracic surgeries. In this review, we focus on the potential pathogenic mechanisms and pre-clinical transcriptomic evidence for identifying potential mediators of post-MI depression. We first summarize the conventional mechanistic understanding that leads to the current clinical management of post-MI depression with the use of selective serotonin reuptake inhibitors (SSRIs) and cognitive behavior and exercise therapies. We further envisage a possible role played by certain chemokines, e.g., Chemokine (C-X-C motif) ligand 12 (CXCL12) and Chemokine (C-C motif) ligand 2 (CCL22), in serving as signaling molecules to connect the MI-induced heart damage to the pro-depressive changes in brain during the post-MI period. Future in-depth investigations into this chemokine hypothesis will be instrumental in developing new chemokine-targeted therapies for better management of the cardiac patients suffering from post-MI depression.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 9","pages":"913-926"},"PeriodicalIF":1.8,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediating role of inflammatory indicators in the association between sleep status and blood pressure in centenarians: evidence from China Hainan Centenarian Cohort Study.","authors":"Qiao Li, Sheng-Shu Wang, Guang-Dong Liu, Jian-Hua Wang, Ya-Li Zhao, Miao Liu, Yao He, Shan-Shan Yang","doi":"10.26599/1671-5411.2024.09.009","DOIUrl":"10.26599/1671-5411.2024.09.009","url":null,"abstract":"<p><strong>Objectives: </strong>To conduct a comprehensive analysis in Hainan centenarians on the link between sleep status and their blood pressure status. Furthermore, the study also aims to explore how inflammatory indicators may mediate the relationship.</p><p><strong>Methods: </strong>The China Hainan Centenarians Cohort Study (CHCCS) collected baseline data on sleep status, inflammatory indicators, and blood pressure data. The study used a mediation model to investigate how inflammatory indicators mediate the relationship between sleep status and blood pressure status.</p><p><strong>Result: </strong>In this study, a total of 967 centenarians were included. The prevalence of hypertension among the centenarians was 71.4%. The analysis showed that centenarians with poor sleep quality had a 43% higher risk of hypertension compared to those with normal sleep quality (OR = 1.43, 95% CI: 1.03-1.97). Additionally, centenarians with nighttime sleep durations of ≤ 6 h or > 9 h had higher proportions of high pulse pressure (PP), with OR values of 1.76 (95% CI: 1.18-2.63) and 2.07 (95% CI: 1.34-3.19), respectively. Mediation analysis illustrated that complement C3 played a mediating role in the relationship between sleep quality and hypertension, with an effect ratio of 2.4%. Similarly, lymphocyte count, the neutrophil-to-lymphocyte ratio (NLR), and the systemic immune-inflammation index (SII) were identified as mediating factors in the association between nighttime sleep duration and high PP, with effect ratios of 91.22%, 36.93%, and 0.20%, respectively.</p><p><strong>Conclusion: </strong>In centenarians, poor sleep quality raises the risk of hypertension, with complement C3 as a mediator. Additionally, nighttime sleep durations of ≤ 6 h or > 9 h increases the risk of high PP, mediated by lymphocyte count, NLR, and SII.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 9","pages":"874-883"},"PeriodicalIF":1.8,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter aortic valve implantation versus surgery: 4-year survival according to life expectancy.","authors":"Vittoria Lodo, Enrico G Italiano, Edoardo Zingarelli, Claudio Pietropaolo, Stefano Pidello, Gabriella Buono, Paolo Centofanti","doi":"10.26599/1671-5411.2024.09.005","DOIUrl":"10.26599/1671-5411.2024.09.005","url":null,"abstract":"<p><strong>Background: </strong>In the last years, transcatheter aortic valve implantation (TAVI) indication has expanded to younger and lower risk patients. Consequently, interest in mid and long-term follow up and in the role of life expectancy, as a key factor for selecting the most tailored treatment, has grown. The aim of this retrospective study is to compare the 4-year survival of patients who underwent aortic valve replacement (AVR) <i>vs</i>. TAVI at our department.</p><p><strong>Methods: </strong>From September 2017 to December 2020, 673 consecutive patients with severe aortic valve stenosis were enrolled for AVR (<i>n</i> = 283) or TAVI (<i>n</i> = 390). Inclusion criteria was isolated severe aortic stenosis, while exclusion criteria were redo surgery, valve-in-valve procedure and the need for concomitant surgical procedures. Based on the Lee index, patients were divided into four groups according to their 4-year life expectancy. Four-year survival was assessed and reported using the Kaplan-Meier method. A multivariate regression analysis of risk factors for 4-year mortality was performed.</p><p><strong>Results: </strong>Four years survival is always superior in the AVR patients (89.8% <i>vs.</i> 75.6%, <i>P</i> < 0.001). Surgery is associated with a higher incidence of acute kidney injury (23% <i>vs.</i> 5.1%, <i>P</i> < 0.001), while TAVI is related to a higher incidence of new onset left bundle branch block (0 <i>vs.</i> 23.8%, <i>P</i> < 0.001), pace-maker implantation (2.5% <i>vs.</i> 11.8%, <i>P</i> = 0,02) and mild-to-moderate paravalvular leak (0.3% <i>vs.</i> 5.4%, <i>P</i> < 0.001). The independent risk factors for 4-years mortality are post-procedural AKI, poor mobility and transcatheter procedure.</p><p><strong>Conclusion: </strong>In our analysis, 4 years survival is always superior in the AVR patients. Life expectancy is a key factor for selecting the most appropriate approach for each patient. A longer follow up is mandatory before extending TAVI indication to patients with a long-life expectancy.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 9","pages":"846-854"},"PeriodicalIF":1.8,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}