Abstract Body (Do not enter title and authors here): Background:The detection of Aortic Stenosis (AS) remains problematic. Applying the properties of the National Echo Database of Australia (NEDA) linked to Australia’s National Health Data Hub, we characterise the prevalence of AS and the health care provided to those affected.
Methods:We examined 1,187,000 (40 sites) Australians aged ≥18y undergoing echocardiography (2010-2021). We applied ASE criteria to all reported aortic valve parameters and identified mild, moderate and severe AS (age and sex basis). Applying conservative rates to the population of men (8.0 to 9.7 million) and women (8.8 to 10.1 million) aged ≥18y with matching proportion of cases per annum with AS linked to survival, we dervribe the clinical/hemodynamic population of AS cases in Australia. Using the recently available entirety of health records within Australian NHDH we identify all AS-related hospital episodes from 16.3 million individuals.
Results: 8.3% - 73.2±13.9y), 1.8% - 74.6±13.8y and 2.5% - 79.6±11.9y had evidence of mild (mAV gradient 12.1±3.2 mmHg/vMax 2.34±0.27 m/s/AV area 1.83±0.57 cm²), moderate (24.9±5.4 mmHg / 3.30±0.31 m/s / 1.40±0.37 cm²) and severe AS (32.6±17.5 mmHg/ 3.60±0.97 m/s/0.80±0.23 cm²) respectively. 3.9% of men v's 2.2% of women had their AV replaced. FIGURE 1 shows the annual number of Australians with haemodynamically confirmed mild, moderate and severe AS (597,053 men aged 62.8±17.3y and 651,668 women aged 63.4±18.7y) compared to the number of primary hospital admissions during the period 2010-21. Total cases rose from ~47,000 to ~60,100 men (>mild AS) and ~49,000 to ~65,000 women-more cases of mild and moderate AS. FIGURE 2 shows the cumulative prevalence during 2010-2020 (based on survival profile of each annual cohort). The prevalence of hemodynamically detected AS in Australia from 2010 onwards have steadily risen to ~207,000 men and 229,000 women by the start of 2021. AT THE AHA CONGRESS, we will present the individually linked to entire health record of AS specific hospitalisations, co-morbidity and proceedures from a total of 92.9 million hospital episodes nationally.
Conclusions:There appears to be is a significant and increasing burden of echocardiographic evidence of Aortic Stenosis that is not concordant with intervention as per clinical guidelines. The gap between disease and treatment appears to be more prominent for women.