Abstract 3108: Prevalence, Referral Patterns, Testing and Surgery in Aortic Stenosis: Leaving Women and Elderly Patients Behind?
Objective. This study describes the prevalence of aortic stenosis (AS) using a privately insured employer claims database and extrapolates the estimates to the adult U.S. population. Differences associated with gender and advanced age in diagnostic testing, specialty referral, and aortic valve replacement (AVR) are investigated.
Methods. The prevalence of AS in a U.S. employer claims database of 5 million beneficiaries was calculated by age group and gender and extrapolated to the 2005 U.S. population. Patients were categorized as symptomatic if diagnosed with angina, dyspnea, syncope, or heart failure in the year before or after AS diagnosis. Specialist was defined as a cardiologist or surgeon.
Results. The extrapolated prevalence of AS in the U.S. in 2005 was 1.5% in adults (age >=18) and 5.9% in those >=65 years. Approximately 56% of the 25,309 AS-diagnosed adults in the sample were diagnosed with symptoms. Of those, 55% were seen only by a non-specialist at the time of diagnosis, and 57% of those did not see a cardiologist or a surgeon in the following year. Among patients over age 65 diagnosed with AS, females and patients over 80 years were seen by a specialist, underwent testing, and underwent AVR at rates lower than males (Table⇓, *p<0.05 [chi-squared test] for comparison between males and females and between age groups).
Conclusion. In 2005 ~ 3.4 million U.S. adults were estimated to have a diagnosis of AS. Of those 56% had symptoms diagnosed in the year before or after AS diagnosis. Advanced age and female sex were associated with lower incidence of specialist visits, diagnostic testing, and AVR in the year after diagnosis.