Trends of Hospitalizations in the United States from 2000 to 2012 of Patients &gt;60 Years With Aortic Valve Disease

Badheka, Apurva; Singh, Vikas; Patel, Nileshkumar; Arora, Shilpkumar; Patel, Nilay; Thakkar, Badal; Jhamnani, Sunny; Pant, Sadip; Chothani, Ankit; Macon, Conrad; Panaich, Sidakpal; Patel, Jay; Manvar, Sohilkumar; Savani, Chirag; Bhatt, Parth; Panchal, Vinaykumar; Patel, Neil; Patel, Achint; Patel, Darshan; Lahewala, Sopan; Deshmukh, Abhishek; Mohamad, Tamam; Mangi, Abeel A.; Cleman, Michael; Forrest, John K.

doi:10.1016/j.amjcard.2015.03.053

Cited by 31 publications

(18 citation statements)

References 17 publications

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“…Regarding disparity in the incidence of AS, historical echocardiographic data showed that the risk of developing AS was 2‐fold higher in men than in women20; however, nationwide claim‐based studies in hospitalized patients showed a less pronounced disparity in AS diagnosis between men and women. Among 113 847 patients admitted with an aortic valve disorder diagnosis in the United States, 55.1% were men 21. A similar study in Sweden showed that men constituted 52% of all patients newly diagnosed with AS 22.…”

Section: Discussionmentioning

confidence: 92%

Sex Differences in the Utilization and Outcomes of Surgical Aortic Valve Replacement for Severe Aortic Stenosis

Chaker

Badhwar

Alqahtani

et al. 2017

JAHA

148

124

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BackgroundStudies assessing the differential impact of sex on outcomes of aortic valve replacement (AVR) yielded conflicting results. We sought to investigate sex‐related differences in AVR utilization, patient risk profile, and in‐hospital outcomes using the Nationwide Inpatient Sample.Methods and ResultsIn total, 166 809 patients (63% male and 37% female) who underwent AVR between 2003 and 2014 were identified, and 48.5% had a concomitant cardiac surgery procedure. Compared with men, women were older and had more nonatherosclerotic comorbid conditions including hypertension, diabetes mellitus, obstructive pulmonary disease, atrial fibrillation/flutter, and anemia but fewer incidences of coronary and peripheral arterial disease and prior sternotomies. In‐hospital mortality was significantly higher in women (5.6% versus 4%, P<0.001). Propensity matching was performed to assess the impact of sex on the outcomes of isolated AVR and yielded 28 237 matched pairs of male and female participants. In the propensity‐matched groups, in‐hospital mortality was higher in women (3.3% versus 2.9%, P<0.001). Along with vascular complications and blood transfusion (6% versus 5.6%, P=0.027 and 40.4% versus 33.9%, P<0.001, respectively). Rates of stroke, permanent pacemaker implantation, and acute kidney injury requiring dialysis were similar (2.4% versus 2.4%, P=0.99; 6% versus 6.3%, P=0.15; and 1.4% versus 1.3%, P=0.14, respectively). Length of stay median and interquartile range were both similar between groups (7±6 days). Rates of nonhome discharge were higher among women (27.9% versus 19.6%, P<0.001).ConclusionsWomen have worse in‐hospital mortality following AVR compared with men. Coupled with the accumulating evidence suggesting higher magnitude of benefit of transcatheter AVR over AVR in women, women should perhaps be offered transcatheter AVR over AVR at a lower threshold than men.

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Section: Discussionmentioning

confidence: 92%

Sex Differences in the Utilization and Outcomes of Surgical Aortic Valve Replacement for Severe Aortic Stenosis

Chaker

Badhwar

Alqahtani

et al. 2017

JAHA

148

124

View full text Add to dashboard Cite

show abstract

“…Each entry also contains data regarding demographic information, insurance status, comorbidities, primary and secondary procedures, hospitalization outcome, length of stay, and cost of care. Data from the NIS have previously been used to identify, track, and analyze national trends in healthcare usage, access, disparity of care, hospitalization rate, and outcomes for various diagnoses and major procedures .…”

Section: Methodsmentioning

confidence: 99%

Transcatheter aortic valve replacement versus surgical aortic valve replacement in patients with cirrhosis

Thakkar

Patel

Mohamad³

et al. 2015

Cathet Cardio Intervent

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“…Diseases of heart valves and the ascending aorta, together with their surgical interventions, are associated with considerable morbidity and mortality, not least among older adults 1, 2, 3, 4, 5. Prevalences of these diseases are relatively high and increase with age 6.…”

Section: Introductionmentioning

confidence: 99%

Traditional Cardiovascular Risk Factors and Their Relation to Future Surgery for Valvular Heart Disease or Ascending Aortic Disease: A Case–Referent Study

Ljungberg

Johansson

Engström

et al. 2017

JAHA

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BackgroundRisk factors for developing heart valve and ascending aortic disease are based mainly on retrospective data. To elucidate these factors in a prospective manner, we have performed a nested case–referent study using data from large, population‐based surveys.Methods and ResultsA total of 777 patients operated for heart valve disease or disease of the ascending aorta had previously participated in population‐based health surveys in Northern Sweden. Median time (interquartile range) from survey to surgery was 10.5 (9.0) years. Primary indications for surgery were aortic stenosis (41%), aortic regurgitation (12%), mitral regurgitation (23%), and dilatation/dissection of the ascending aorta (17%). For each case, referents were allocated, matched for age, sex, and geographical area. In multivariable models, surgery for aortic stenosis was predicted by hypertension, high cholesterol levels, diabetes mellitus, and active smoking. Surgery for aortic regurgitation was associated with a low cholesterol level, whereas a high cholesterol level predicted surgery for mitral regurgitation. Hypertension, blood pressure, and previous smoking predicted surgery for disease of the ascending aorta whereas diabetes mellitus was associated with reduced risk. After exclusion of cases with coronary atherosclerosis, only the inverse associations between cholesterol and aortic regurgitation and between diabetes mellitus and disease of the ascending aorta remained.ConclusionsThis is the first truly prospective study of traditional cardiovascular risk factors and their association with valvular heart disease and disease of the ascending aorta. We confirm the strong association between traditional risk factors and aortic stenosis, but only in patients with concomitant coronary artery disease. In isolated valvular heart disease, the impact of traditional risk factors is varying.

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Trends of Hospitalizations in the United States from 2000 to 2012 of Patients >60 Years With Aortic Valve Disease

Cited by 31 publications

References 17 publications

Sex Differences in the Utilization and Outcomes of Surgical Aortic Valve Replacement for Severe Aortic Stenosis

Sex Differences in the Utilization and Outcomes of Surgical Aortic Valve Replacement for Severe Aortic Stenosis

Transcatheter aortic valve replacement versus surgical aortic valve replacement in patients with cirrhosis

Traditional Cardiovascular Risk Factors and Their Relation to Future Surgery for Valvular Heart Disease or Ascending Aortic Disease: A Case–Referent Study

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