Background
Trends in mortality from aortic stenosis across European countries are not well
understood, especially given the significant growth in transcatheter aortic valve
implantation (TAVI) in the last 10 years.
Methods
Age-standardised death rates were extracted from the World Health Organisation
Mortality Database, using the International Classification of Diseases 10th edition
code for non-rheumatic aortic stenosis for those aged >45 years between 2000 and
2017. The UK and countries from the European Union with at least 1,000,000
inhabitants and at least 50% available datapoints over the study period were included:
a total of 23 countries. Trends were described using Joinpoint regression analysis.
Results
No reductions in mortality were demonstrated across all countries 2000-2017. Large
increases in mortality were found for Croatia, Poland and Slovakia for both sexes
(>300% change). Mortality plateaued in Germany from 2008 in females and 2012 in
males, whilst mortality in the Netherlands declined for both sexes from 2007. Mortality
differences between the sexes were observed, with greater mortality for males than
females across most countries.
Conclusions
Mortality from aortic stenosis has increased across Europe from 2000 to 2017. There
are, however, sizable differences in mortality trends between Eastern and Western
European countries. The need for health resource planning strategies to specifically
target AS, particularly given the expected increase with aging populations, is
highlighted.