Aortic Valve Sclerosis in High-Risk Coronary Artery Disease Patients

This record contains raw data related to the article “Aortic Valve Sclerosis in High-Risk Coronary Artery Disease Patients”<strong>Background:</strong> Current knowledge regarding the relationship between aortic valve sclerosis (AVSc), cardiovascular risk factors, and mortality in patients with known coronary artery disease (CAD) is still unclear. The present study aimed at investigating the prevalence of AVSc as well as its association with long-term all-cause mortality in high-risk CAD patients that has never been explored in large cohorts thus far. <strong>Methods and Results:</strong> In this retrospective and observational cohort study we enrolled high-risk CAD patients, hospitalized at Centro Cardiologico Monzino (CCM), Milan, Italy, between January 2006 and December 2016. The morphology and function of the aortic valve were assessed from the recorded echocardiographic images to evaluate the presence of AVSc, defined as a non-uniform thickening of the aortic leaflets with no consequences on hemodynamics. Data on 5-year all-cause mortality was retrieved from a Regional database. Of the 5,489 patients initially screened, 4,938 (mean age 67 ± 11 years, 3,954 [80%] men) were enrolled in the study. In the overall population, AVSc was detected in 2,138 (43%) patients. Multivariable LASSO regression revealed that age, female gender, diabetes mellitus, previous MI, and left ventricular ejection fraction were independently associated with AVSc. All-cause mortality (adjusted hazard ratio: 1.29, 95%CI: 1.05-1.58) was significantly higher in AVSc than in non-AVSc patients. <strong>Conclusions:</strong> AVSc is frequently detected in high-risk CAD patients and is associated with long-term mortality. Our findings corroborate the hypothesis that AVSc is an underestimated marker of systemic cardiovascular risk. Thus, AVSc detection may be used to improve long-term risk stratification of high-risk CAD patients.本数据集包含与论文《高危冠状动脉疾病患者的主动脉瓣硬化》相关的原始数据。 <strong>背景：</strong>目前，针对确诊冠状动脉疾病（CAD）患者的主动脉瓣硬化（AVSc）、心血管危险因素与死亡率之间的关联，学界尚无明确认知。本研究旨在探究高危CAD患者中AVSc的患病率及其与长期全因死亡率的关联——该主题此前尚未在大型队列研究中得到深入探索。 <strong>方法与结果：</strong>本研究为回顾性观察队列研究，纳入了2006年1月至2016年12月期间，于意大利米兰蒙奇诺心脏中心（Centro Cardiologico Monzino, CCM）住院的高危CAD患者。研究通过受试者的超声心动图记录评估主动脉瓣的形态与功能，以此判断是否存在AVSc——AVSc被定义为主动脉瓣叶不均匀增厚，但未对血流动力学产生影响。研究从区域数据库中提取了受试者的5年全因死亡率数据。初筛的5489例患者中，最终有4938例纳入本研究，受试者平均年龄为67±11岁，其中男性3954例，占比80%。在全部纳入的受试者中，共有2138例（43%）检出AVSc。多变量LASSO回归分析显示，年龄、女性性别、糖尿病、既往心肌梗死（MI）以及左心室射血分数与AVSc存在独立关联。AVSc阳性患者的全因死亡率显著高于AVSc阴性患者，校正后风险比为1.29，95%置信区间为1.05~1.58。 <strong>结论：</strong>高危CAD患者中常可检出AVSc，且该指标与长期死亡率存在显著关联。本研究结果印证了“AVSc是被低估的系统性心血管风险标志物”这一假说。因此，AVSc检测可用于优化高危CAD患者的长期风险分层。