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. 2023 Jul;82(1):29-34.
doi: 10.1016/j.jjcc.2023.03.007. Epub 2023 Mar 22.

Valvular heart disease in Japan: Characteristics and treatment of patients in acute care hospitals in 2019

Chisato Izumi  1 , Rei Matsuyama  2 , Miyoshi Asaoka  2 , Kosuke Iwasaki  3 , Tomomi Takeshima  3 , Shannon Murphy  4 , Lida Teng  5 , Ataru Igarashi  6
Affiliations
Free article

Valvular heart disease in Japan: Characteristics and treatment of patients in acute care hospitals in 2019

Chisato Izumi et al. J Cardiol. 2023 Jul.
Free article

Abstract

Background: Valvular heart disease (VHD) is one of the commonest causes of cardiovascular morbidity and mortality worldwide, with acquired VHD especially prevalent in countries with aging populations. The scope and pattern of disease are not well understood, as some patients are asymptomatic and available options for invasive treatment vary by affected valve. We sought to understand the burden of VHD in Japan including the distribution of patients by valve disease type and age, using administrative claims data from acute care hospitals.

Methods: This was a retrospective descriptive study of patients with VHD diagnosis and at least one record of echocardiography in 2019 documented in the Medical Data Vision database. Affected valve(s) and type of valve disease were characterized using ICD-10 codes; patients undergoing invasive treatment for VHD at the same facility and during the same year as their diagnosis were assessed using procedure codes.

Results: Of 203,398 patients with VHD diagnosis and a record of echocardiography in 2019, 49.0 % had a mitral valve disorder, 44.9 % aortic valve, 22.9 % tricuspid valve, and 2.2 % pulmonic valve (14.9 % of patients had more than one disordered valve). A total of 7201 patients (<4 % of the total diagnosed population) received invasive treatment for VHD in 2019 at the diagnosing hospital. Patients with aortic stenosis (AS) had the highest mean age, at 79 years. Although mitral regurgitation was the most common VHD among diagnosed patients, AS predominated in the cohort of treated patients. A substantial portion of patients undergoing treatment for AS were age 85 years or older (27.2 %).

Conclusions: The cohort of treated patients in 2019 was a small fraction of the total population with a VHD diagnosis in that year. Wide availability of transcatheter treatment for AS in Japan may be allowing more elderly patients to receive intervention than in other types of VHD.

Keywords: Epidemiology; Heart valve; Valve disease; Valve replacement.

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Conflict of interest statement

Declaration of competing interest CI and LT have no conflict of interest. RM and MA are employees of Edwards Lifesciences Limited. SM is employee of Edwards Lifesciences Corporation. KI and TT are employees of Milliman Inc., which has received consultancy fees from Edwards Lifesciences Corporation. AI received consulting fees and lecture fees from GSK Japan Inc., MSD Inc., Moderna Japan Inc., Pfizer Japan Inc., Sanofi-Pasteur Inc., Novartis Pharma K.K., AbbVie GK, Astellas Pharma Inc., Chugai Pharmaceutical Co. Ltd., Asahi Kasei Pharma Inc., Novo Nordisk Pharma Inc., Eisai Inc., Beckton Dickinson and Company, Maruho Co. Ltd., Ono Pharmaceutical Inc., Sato Pharmaceutical Inc., Sumitomo Dainippon Pharma Inc., and Eli Lilly Japan K.K., outside the submitted work, and research grants from Taiho Pharmaceutical Co. Ltd., GSL Behring Japan Inc., Gilead Science K.K., Fuji Film K.K., Terumo Corporation., Takeda Pharmaceutical Inc., Boston Scientific Japan Inc., DeSC Healthcare Inc., Otsuka Pharmaceutical K.K., Varian Medical systems and Intuitive Surgical GK., outside the submitted work.

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