Ten-year trends in the incidence, treatment and outcomes of patients with mitral stenosis in Korea

Abstract

Objective: Mitral stenosis increases the risk of atrial fibrillation (AF) and stroke. Large data underlying the trend in incidence, treatment and outcomes of mitral stenosis are lacking.

Methods: Based on the Health Insurance Review and Assessment Service database in Republic of Korea, patients who were diagnosed with mitral stenosis between 2007 and 2016 were enrolled. Trends in the incidence rate and changing patterns of treatment and outcome for stroke and systemic embolism and intracranial haemorrhage (ICH) were analysed.

Results: A total of 42 075 patients (mean age 60.7±13.5 years, 13 303 (31.6%) male) were included in the present study. The number included 27 824 (66.1%) patients with mitral stenosis and comorbid AF. The age-standardised annual incidence rate per 100 000 of mitral stenosis in Korea decreased remarkably from 10.3 to 3.6 over 10 years. The use of anticoagulation therapy increased consistently. The annual incidence of stroke and systemic embolism showed signs of plateau, while the incidence of ICH increased.

Conclusions: The overall incidence rate of mitral stenosis in Korean population has decreased remarkably. As increasing the use of vitamin K antagonist, the annual incidence rate of ICH was increased but the rate of stroke incidence reached a plateau. Alternative effective anticoagulation strategy should be investigated.

Keywords: anticoagulation; incidence rate; intracranial haemorrhage; mitral stenosis; stroke; systemic embolism.

Figure 1

Age-standardised annual incidence rate per 100 000, prevalence rate for the 2008–2017 period of mitral stenosis in Korea.

Figure 2

Trend showing the prevalence rate of atrial fibrillation (AF) in patients with mitral stenosis (MS).

Figure 3

Trend for antithrombotic therapy for patients with mitral stenosis combined with atrial fibrillation (AF).

Figure 4

Annual incidence rate of outcome for all the patients diagnosed with mitral stenosis with and without atrial fibrillation (AF). ICH, intracranial haemorrhage.