Table 3

Baseline predictors of AVR denial in symptomatic* patients with decision (N=1608)

	Univariate OR (95% CI)	Univariate p value	Multivariate† OR (95% CI)	Multivariate† p value
Referring by cardio (vs other referring physician)	0.791 (0.605 to 1.034)	0.086	0.594 (0.426 to 0.828)	0.002
Age > versus ≤80 years	1.562 (1.240 to 1.968)	<0.001	1.390 (1.041 to 1.858)	0.026
Severe frailty	2.349 (1.432 to 3.855)	0.001	2.036 (1.096 to 3.781)	0.024
EuroSCORE II> versus ≤2.39%	1.051 (0.833 to 1.327)	0.676	0.673 (0.487 to 0.930)	0.016
Comorbidities
Renal impairment‡	1.679 (1.297 to 2.172)	<0.001	1.466 (1.071 to 2.007)	0.017
COPD	1.463 (1.055 to 2.030)	0.023	1.450 (0.955 to 2.202)	0.081
Diabetes§	1.040 (0.697 to 1.551)	0.847	1.343 (0.828 to 2.178)	0.232
Endocarditis	3.222 (0.802 to 12.943)	0.099	2.198 (0.476 to 10.157)	0.313
2-year life expectancy <25%¶	1.614; (1.078 to 2.418)	0.020	0.779 (0.439 to 1.382)	0.393
Cardiac-related symptoms
Chest pain	0.831 (0.640 to 1.081)	0.168	0.780 (0.566 to 1.076)	0.130
Shortness of breath	0.493 (0.343 to 0.710)	<0.001	0.568 (0.358 to 0.900)	0.016
Dizziness on exertion/syncope	0.961 (0.736 to 1.254)	0.770	0.788 (0.566 to 1.096)	0.157
NYHA class III/IV	0.484 (0.381 to 0.615)	<0.001	0.452 (0.333 to 0.613)	<0.001
Angina class III/IV	1.090 (0.665 to 1.785)	0.733	1.068 (0.582 to 1.959)	0.832
Echocardiographic parameters
Indexed AVA ≤versus>0.39 cm²/m²	0.604 (0.471 to 0.775)	<0.001	0.566 (0.416 to 0.771)	<0.001
V_max >versus≤4.3 m/s	0.813 (0.637 to 1.037)	0.096	1.207 (0.795 to 1.832)	0.378
Mean AV gradient >versus≤45.0 mm Hg	0.738 (0.584 to 0.931)	0.010	0.776 (0.511 to 1.178)	0.234
LVEF ≤versus>58%	0.828 (0.655 to 1.048)	0.116	0.511 (0.382 to 0.683)	<0.001
PASP >versus ≤37.0 mm Hg	1.146 (0.894 to 1.468)	0.282	0.898 (0.664 to 1.214)	0.485
AVA <1 cm² and mean AV gradient <40 mm Hg	1.538 (1.191 to 1.985)	0.001	1.371 (0.915 to 2.054)	0.126
Aortic regurgitation grade III/IV	1.092 (0.699 to 1.706)	0.699	0.886 (0.520 to 1.509)	0.656
Mitral regurgitation grade III/IV	2.124 (1.524 to 2.961)	<0.001	1.995 (1.299 to 3.064)	0.002
Tricuspid regurgitation grade III/IV	2.045 (1.385 to 3.019)	<0.001	2.029 (1.246 to 3.304)	0.004
LV-ESD >versus ≤30.0 mm	0.586 (0.440 to 0.782)	<0.001	0.693 (0.476 to 1.009)	0.056
LV-EDD >versus ≤47.0 mm	0.606 (0.471 to 0.780)	<0.001	0.773 (0.564 to 1.059)	0.108
IVS>versus ≤13.3 mm	1.202 (0.937 to 1.542)	0.148	1.350 (1.003 to 1.817)	0.048
PW >versus ≤12.0 mm	0.957 (0.733 to 1.249)	0.745	0.850 (0.622 to 1.163)	0.311
Relative wall thickness >versus ≤0.51	1.183 (0.908 to 1.541)	0.214	1.063 (0.778 to 1.454)	0.701
LV mass >versus ≤233.9 g	0.777 (0.596 to 1.012)	0.061	1.047 (0.760 to 1.443)	0.778
LV mass indexed >versus ≤126.3 g/m²	1.149 (0.870 to 1.518)	0.327	1.330 (0.956 to 1.851)	0.091
LVEF <50% and PASP ≥55 mm Hg	0.907 (0.696 to 1.182)	0.470	0.815 (0.560 to 1.188)	0.288

All continuous variables were converted to binary predictors using the median of the overall study population as a cut off.
*Symptomatic defined as having ≥1 of the following (presumed to be AS related): chest pain, shortness of breath, dizziness on exertion/syncope.
†Adjusted for age, severefrailty, renal insufficiency, COPD, V_max, mean AV gradient, LVEF, mitral regurgitation grade III/IV and tricuspid regurgitation grade III/IV.
‡Creatinine clearance rate <50 mL/min or dialysis.
§Insulin dependent.
¶2-year life expectancy< 25% was assessed by the dedicated nurses and physicians.
AV, aortic valve; AVA, aortic valve area; AVR, aortic valve replacement; COPD, chronic obstructive pulmonary disease; IVS, interventricular septum; LV, left ventricular; LV-EDD, left ventricular end diastolic diameter; LVEF, left ventricular ejection fraction; LV-ESD, left ventricular end systolic diameter; NYHA, New York Heart Association; PASP, pulmonary artery systolic pressure; PW, posterior wall; V_max, peak AV jet velocity.