Temporal trends in the incidence and mortality of calcified arotic valve disease in the nordic countries over the past 30 years

Abstract Introduction Calcified aortic valve is imposes significant burden due to the associated morbidity and mortality. With the increasing life expectancy across Europe, the incidence of calcified aortic valve is on the rise. Therefore, thorough evaluation of the temporal trends in the incidence and mortality of calcified aortic valve is of significance in risk stratification and tailored management. Methods Data from the Global Burden of Disease database was retrieved to evaluate the temporal trends in the age-standardized incidence rate (ASIR) and age- standardized mortality rate (ASMR) of calcified aortic valve disease in the Nordic countries (Finland, Sweden, Denmark, Iceland, and Norway) over the period 1990- 2019. Joinpoint analysis software was used to calculate Annual Percent Change (APC) and Average Annual Percent Change (AAPC). Gender stratification was performed to evaluate for gender disparities. Results During the period of 1990-2019, an estimated total of 509,762 cases of calcified aortic valve disease with a male predominance of 51.4% were reported. A statistically significant increase in the ASIR was noted across all 5 Nordic countries, with the most prominent increase observed in Denmark with an AAPC of 1.94 (95CI% 1.89 to 1.99, p<0.001), followed by Norway (AAPC 1.37), Sweden (AAPC 1.25), Iceland (1.05), and Finland (0.53). Gender stratification revealed statistically significant incline in the ASIR across all 5 nations in both males and females, with the latter experiencing a more profound increase. In terms of calcified aortic valve-associated mortality, an estimated total of 77,940 deaths with a 61.4% female predominance were reported over 3 decades. A statistically significant incline in the ASMR was noted in Denmark, Finland, Iceland and Norway, with the most profound incline noted in Denmark with an AAPC of 1.67 (95%CI 1.45 to 1.91, p<0.001), followed by Iceland (AAPC 0.74). On the contrary, Sweden encountered a statistically insignificant increase with an AAPC of 0.02 (95%CI -0.21 to 0.21, p=0.89). Gender stratification revealed interesting findings where females in Sweden encountered a statistically insignificant increase in the ASMR with an AAPC of 0.14 (95%CI -0.13 to 0.42, p=0.20), whereas males in Sweden encountered a statistically significant decline in ASMR with AAPC of -0.26 (95%CI -0.50 to -0.03, p=0.03). Conclusion Over a span of 3 decades, calcified aortic valve disease encountered a statistically significant incline in incidence across the 5 Nordic nations in both males and females. A statistically significant increase in the ASMR was also noted in most countries, except for Sweden. These findings mandate prompt recognition and intervention to tackle the associated burden.