Epidemiological features of aortic stenosis in a french nationwide study: 10-year trends and new challenges

Abstract

BACKGROUND: Aortic stenosis (AS) is one of the most common forms of valvular heart disease. Our aim was to estimate the burden of AS in the hospital in France, describe patient characteristics, and evaluate the mortality rate and temporal trends. METHODS AND RESULTS: All patients hospitalized for AS in France between 2006 and 2016 were identified from the national hospital discharge database. Patients’ sociodemographic, medical, and surgical characteristics and temporal trends were described. All AS-related deaths between 2000 and 2014 were identified using death certificates. In 2016, 26 071 patients were hospitalized for AS: 56.5% were men with an average age of 77 years. The all-cause mortality rate at 1 year postindex stay was 11%. The rate of patients hospitalized for AS increased by 59% between 2006 and 2016, reaching 38.7/100 000 person-years in 2016. This increase was most pronounced in patients aged >75 years. The number of transcatheter aortic valve implantations increased following their introduction in 2010. In 2016, 44% of patients were treated with aortic valve surgery during the index hospital stay or following year (mean age, 71.5 years), and 34% were treated with transcatheter aortic valve implantation (mean age, 83.0 years). In 2014, 6186 deaths caused by AS were identified in death certificates: 41.6% were men with an average age of 87 years. The age-standardized mortality rate increased by 5% between 2000 and 2014, reaching 8.5/100 000 person-years in 2014. CONCLUSIONS: The rate of patients hospitalized for AS increased in recent years in line with the higher life expectancy and introduction of transcatheter aortic valve implantation. Mortality increased more moderately.