Uncovering the treatable burden of severe aortic stenosis in the UK

Geoffrey A. Strange, Simon Stewart, Nick Curzen, Simon Ray, Simon Kendall, Peter Braidley, Keith Pearce, Renzo Pessotto, David Playford, Huon H. Gray

Research output: Contribution to journalArticlepeer-review

Abstract

ObjectiveTo estimate the population prevalence and treatable burden of severe aortic stenosis (AS) in the UK.MethodsWe adapted a contemporary model of the population profile of symptomatic and asymptomatic severe AS in Europe and North America to estimate the number of people aged ≥55 years in the UK who might benefit from surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI).ResultsWith a point prevalence of 1.48%, we estimate that 291 448 men and women aged ≥55 years in the UK had severe AS in 2019. Of these, 68.3% (199 059, 95% CI 1 77 201 to 221 355 people) would have been symptomatic and, therefore, more readily treated according to their surgical risk profile; the remaining 31.7% of cases (92 389, 95% CI 70 093 to 144 247) being asymptomatic. Based on historical patterns of intervention, 58.4% (116 251, 95% CI 106 895 to 1 25 606) of the 199 059 symptomatic cases would qualify for SAVR, with 7208 (95% CI 7091 to 7234) being assessed as being in a high, preoperative surgical risk category. Among the remaining 41.6% (82 809, 95% CI 73 453 to 92 164) of cases potentially unsuitable for SAVR, an estimated 61.7% (51 093, 95% CI 34 780 to 67 655) might be suitable for TAVI. We estimate that 172 859 out of 291 448 prevalent cases of severe AS (59.3%) will subsequently die within 5 years without proactive management.ConclusionsThese data suggest a high burden of severe AS in the UK requiring surgical or transcatheter intervention that challenges the ongoing capacity of the National Health Service to meet the needs of those affected.

Original languageEnglish
Article numbere001783
JournalOpen Heart
Volume9
Issue number1
DOIs
Publication statusPublished - 26 Jan 2022

Keywords

  • aortic valve stenosis
  • cardiac surgical procedures
  • transcatheter aortic valve replacement

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