Abstract 12678: Temporal Trends In Disease Severity And Predicted Surgical Risk In Patients Presenting With A First Echocardiographic Diagnosis Of Aortic Stenosis
Objective: Patients with severe AS and at high risk for surgical aortic valve replacement (SAVR) are now increasingly offered trans-catheter AVR (TAVR). Little data is available to advise healthcare providers about the pattern of disease severity in patients with newly diagnosed AS. We therefore examined the temporal trends in unselected patients with AS in respect to the severity of AS, associated comorbidity and predicted surgical risk.
Methods: Patients presenting for their initial echocardiogram at Duke University Medical Center between Jan 1995 to Dec 2012 with mild, moderate or severe AS were included. Patients with prior valve surgery or congenital heart disease were excluded. The surgical risk was estimated by the EUROscore calculated from the available information.
Results: A total of 6104 patients with AS were identified (Mean age 72.4, 53% male). There was a significant increase over time in the annual overall number of patients presenting with AS (p≤0.001). The proportion of patients presenting with severe AS increased from 16% before 2005 to 22% after 2005 (p>0.001). In patients with severe AS, age on presentation increased significantly over time (p=0.002) accompanied by a significant increase in the logistic EUROscore (p=0.015). The proportion of patients with severe AS presenting with a EUROscore> 20% increased from 9.5% in the period from 1995 to 2005 to 15.4% in those presenting after 2005 (p=0.004).
Conclusion: Aortic stenosis is increasingly present in patients referred for echocardiography. An increasing proportion of the patients presenting with severe AS are older and have a higher predicted surgical risk. These data have potential implications for the planning and structuring of TAVR capacity in the US.
- © 2013 by American Heart Association, Inc.