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Valvular heart disease
Original research
Evolution of the burden of aortic stenosis by sex in the province of Quebec between 2006 and 2018
  1. Philipp Frieden1,2,
  2. Claudia Blais2,3,
  3. Denis Hamel3,
  4. Philippe Gamache3,
  5. Philippe Pibarot1,2,
  6. Marie-Annick Clavel1,2
  1. 1 Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute - Université Laval, Quebec, Quebec, Canada
  2. 2 Université Laval, Quebec, Quebec, Canada
  3. 3 Institut National de Santé Publique du Québec, Quebec, Quebec, Canada
  1. Correspondence to Dr Marie-Annick Clavel, Institut Universitaire de Cardiologie et de Pneumologie de Quebec - Université Laval, Quebec, QC G1V 4G5, Canada; Marie-Annick.Clavel{at}criucpq.ulaval.ca

Abstract

Objectives To evaluate the evolution of the burden of aortic stenosis (AS) by sex in the province of Quebec from 2006–2007 to 2018–2019 and compare the percentage of mortality between people who underwent aortic valve intervention and those who did not.

Methods Persons aged ≥20 years were identified from the Quebec Integrated Chronic Disease Surveillance System using International Classification of Diseases and intervention codes in the hospital files.

Results In 2018, the crude prevalence and incidence of AS were 0.89% (99% CI 0.89 to 0.90) (n=59 025) and 1.39 per 1000 (1.35 to 1.43) (n=9105), respectively. Age-standardised prevalence and incidence of AS diagnosis increased between 2006 and 2018 from 0.67% (0.66 to 0.68) to 0.75% (0.74 to 0.76) and from 0.91 per 1000 (0.88 to 0.95) to 1.20 per 1000 (1.17 to 1.23), respectively. Among incident AS, the age-standardised percentage of valve interventions increased from 11.7% (10.9 to 12.6) to 14.5% (13.9 to 15.3). This increase was only observed in men. The 30-day mortality was stable among patients with incident AS treated conservatively, from 6.9% (6.5 to 7.4) to 7.3% (6.9 to 7.6), and decreased from 7.6% (6.1 to 9.3) to 3.8% (3.1 to 4.7) among operated patients with incident AS. This decrease was only observed in women. However, from 2010, the age-adjusted mortality among prevalent AS tended to be higher in women.

Conclusions In the province of Quebec, age-standardised prevalence and incidence of AS diagnosis increased between 2006 and 2018. Among incident AS, there was an increase in valve intervention in men and a decrease in 30-day mortality in women who underwent valve intervention. Overall and age-standardised mortality remained higher in women.

  • aortic valve stenosis
  • epidemiology

Data availability statement

No data are available. Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data are not available.

https://doi.org/10.1136/heartjnl-2021-319848

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    Data availability statement

    No data are available. Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data are not available.

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    Footnotes

    • Twitter @PPibarot, @ClavelLabo

    • Contributors Substantial contribution to the conception or design of the work: M-AC, CB, PP. Acquisition and analysis of data: DH, PG, PF. Interpretation of data: M-AC, CB, PP, DH, PG, PF. Drafting the work: PF. Revising it critically for important intellectual content: M-AC, CB, PP, DH, PG. Final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: M-AC, CB, PP, DH, PG, PF. Authors acting as guarantor: M-AC, CB

    • Funding M-AC holds the Canada Research Chair in Women’s Valvular Heart Health and PP the Canada Research Chair in Valvular Heart Diseases from CIHR, Ottawa, Ontario, Canada.

    • Competing interests PP received funding from Edwards Lifesciences and Medtronic for echocardiography core laboratory analyses in the field of transcatheter and surgical aortic valve replacement with no direct personal compensation. M-AC received funding from Edwards Lifesciences for CT core laboratory analyses and research grant from Medtronic in the field of surgical aortic valve bioprosthesis with no direct personal compensation. The remaining authors have nothing to disclose.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.