Surgical intervention for Mitral Stenosis: Temporal changes in patient characteristics, incidence, and mortality: a Danish nationwide cohort study

Abstract

Aims: To examine temporal changes in patient characteristics, incidence rate of surgery, and three-year mortality rate for patients undergoing surgery for mitral valve stenosis in Denmark (2001-2021).. Methods and results: Utilizing Danish nationwide registries, we identified all adult patients undergoing first-time MS-intervention (2001-2021). Temporal changes across calendar periods were investigated (2001-2005, 2006-2010, 2011-2015, and 2016-2021). Using Kaplan-Meier estimates, we computed temporal changes in three-year all-cause mortality across calendar periods. With multivariable Cox regression analysis, we assessed adjusted rates of mortality. We included 256 patients (median age 60.3 years, 31.3% males). A decrease in the burden of chronic heart failure was identified (2001-2005:54%, and 2016-2021:20%, p-value<0.001), while the burden of atrial fibrillation seemed stable around 1 in 2. A decrease in rate of surgery was observed: 3.3 cases/million person-years (2001-2005), and 2.2 (2016-2021). The in-hospital mortality was 8.6% and the three-year mortality after discharge was 9.0%. We found no difference over calendar periods in crude estimates or adjusted analysis. Conclusion: From nationwide data (2001-2021), we identified the incidence of surgery, decreased significantly within the past 20 years while all-cause mortality remained stable. The burden of heart failure decreased while the burden of atrial fibrillation remained stable.