{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T07:51:49Z","timestamp":1775980309308,"version":"3.50.1"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with severe aortic stenosis (AS) who are managed medically have a poor prognosis. No contemporary studies have examined resource use and costs associated with medical management for severe AS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Using the Optum Market Clarity Database, which links electronic health records with cost and use data, we identified patients with documented severe AS between 2016 and 2020 who were eligible for aortic valve replacement but did not undergo treatment within 1 year following diagnosis. Outcomes included health care resource use and costs during the 4\u2010year period following the initial diagnosis. Fine\u2010Gray competing risk models estimated use rates, and the Bang\u2010Tsiatis method quantified use and costs while accounting for censoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Over the study period, 6892 patients presented with severe AS, of whom 3334 (48%) were managed medically and 2812 (41%) were similar (based on propensity matching) to those who underwent aortic valve replacement. Over 4\u2009years of follow\u2010up, these patients experienced an average of 1.99 hospitalizations, 1.33 of which were related to a cardiovascular condition. Total costs (including hospitalizations, outpatient care, and pharmacy services) were $126\u2009638 per patient, of which $56\u2009032 was for inpatient care, $31\u2009603 was for outpatient care, and $21\u2009160 was for pharmacy services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In contemporary practice, despite the availability of effective treatment, many patients with severe AS do not undergo aortic valve replacement within the year after diagnosis. These patients with severe AS who are managed medically experience high health care\u2010related resource use and costs. Further research is needed to identify factors associated with lack of timely aortic valve replacement and to address barriers to treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.041889","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T11:06:27Z","timestamp":1756465587000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Contemporary Resource Use and Costs Among Patients With Medically Managed Severe Aortic Stenosis: Results From a US National Claims Database"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7417-6346","authenticated-orcid":false,"given":"Adam S.","family":"Vohra","sequence":"first","affiliation":[{"name":"University of Chicago Medicine","place":["Chicago, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7429-9365","authenticated-orcid":false,"given":"Shannon M. E.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Edwards Lifesciences","place":["Irvine, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4713-4730","authenticated-orcid":false,"given":"Christin A.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Edwards Lifesciences","place":["Irvine, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9163-724X","authenticated-orcid":false,"given":"David J.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation","place":["New York, USA"]},{"name":"St. Francis Hospital","place":["Roslyn, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.116.003287"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.015"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(80)90375-0"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.66.5.1105"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008232"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.112.966002"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.09.595"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.018"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.11.060"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.015879"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.025164"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31819432e5"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz187"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.121.011295"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/87.2.329"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.054072"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000042"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.035236"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.122.012168"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.123.013080"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2021.4641"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.041889","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T06:47:11Z","timestamp":1762930031000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.041889"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,2]]},"references-count":21,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2025,9,2]]}},"alternative-id":["10.1161\/JAHA.125.041889"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.041889","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,2]]},"assertion":[{"value":"2025-02-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e041889"}}