{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:54:18Z","timestamp":1790733258377,"version":"4.1.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T00:00:00Z","timestamp":1633910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Trends in mortality from aortic stenosis across European countries are not well-understood, especially given the significant growth in transcatheter aortic valve implantation (TAVI) in the last 10 years.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Age-standardised death rates were extracted from the World Health Organisation Mortality Database, using the International Classification of Diseases 10th edition code for non-rheumatic aortic stenosis for those aged &amp;gt; 45 years between 2000 and 2017. The UK and countries from the European Union with at least 1,000,000 inhabitants and at least 50% available datapoints over the study period were included: a total of 23 countries. Trends were described using Joinpoint regression analysis.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> No reductions in mortality were demonstrated across all countries 2000\u20132017. Large increases in mortality were found for Croatia, Poland and Slovakia for both sexes (&amp;gt;300% change). Mortality plateaued in Germany from 2008 in females and 2012 in males, whilst mortality in the Netherlands declined for both sexes from 2007. Mortality differences between the sexes were observed, with greater mortality for males than females across most countries.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Mortality from aortic stenosis has increased across Europe from 2000 to 2017. There are, however, sizable differences in mortality trends between Eastern and Western European countries. The need for health resource planning strategies to specifically target AS, particularly given the expected increase with ageing populations, is highlighted.<\/jats:p>","DOI":"10.3389\/fcvm.2021.748137","type":"journal-article","created":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T15:36:03Z","timestamp":1634139363000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Trends in Mortality From Aortic Stenosis in Europe: 2000\u20132017"],"prefix":"10.3389","volume":"8","author":[{"given":"Adam","family":"Hartley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hammond-Haley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic C.","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin D.","family":"Salciccioli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iqbal S.","family":"Malik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramzi Y.","family":"Khamis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Shalhoub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1016\/S0195-668X(03)00201-X","article-title":"A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on Valvular Heart Disease","volume":"24","author":"Iung","year":"2003","journal-title":"Eur Heart J."},{"key":"B2","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1136\/heartjnl-2012-302265","article-title":"The evolving epidemiology of valvular aortic stenosis. The Troms\u00f8 study","volume":"99","author":"Eveborn","year":"2013","journal-title":"Heart."},{"key":"B3","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1016\/j.ijcard.2014.08.053","article-title":"The prevalence of aortic stenosis in the elderly in Iceland and predictions for the coming decades: the AGES-Reykjav\u00edk study","volume":"176","author":"Danielsen","year":"2014","journal-title":"Int J Cardiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1056\/NEJMoa1008232","article-title":"Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery","volume":"363","author":"Leon","year":"2010","journal-title":"New Engl J Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1001\/jamacardio.2020.2497","article-title":"Natural history of asymptomatic severe aortic stenosis and the association of early intervention with outcomes: a systematic review and meta-analysis","volume":"5","author":"Gahl","year":"2020","journal-title":"JAMA Cardiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.acvd.2012.01.005","article-title":"Development of transcatheter aortic valve implantation (TAVI): a 20-year odyssey","volume":"105","author":"Cribier","year":"2012","journal-title":"Arch Cardiovasc Dis."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2485","DOI":"10.1016\/S0140-6736(15)60290-2","article-title":"5-year outcomes of transcatheter aortic valve replacement compared with standard treatment for patients with inoperable aortic stenosis (PARTNER 1): a randomised controlled trial","volume":"385","author":"Kapadia","year":"2015","journal-title":"Lancet"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","article-title":"Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients","volume":"380","author":"Mack","year":"2019","journal-title":"New Engl J Med."},{"key":"B9","unstructured":"BIBAMedTech\n          LondonBIBA MedTechTAVI Monitor2020"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2635","DOI":"10.1093\/eurheartj\/ehy107","article-title":"Annual number of candidates for transcatheter aortic valve implantation per country: current estimates and future projections","volume":"39","author":"Durko","year":"2018","journal-title":"Eur Heart J."},{"key":"B11","doi-asserted-by":"publisher","first-page":"2236","DOI":"10.1001\/jama.2019.6292","article-title":"Mortality due to aortic stenosis in the United States, 2008-2017","volume":"321","author":"Bevan","year":"2019","journal-title":"JAMA."},{"key":"B12","unstructured":"WHO Methods and Data Sources for Country-Level Causes of Death 2000-20162018"},{"key":"B13","first-page":"171","article-title":"Counting the dead and what they died from: an assessment of the global status of cause of death data","volume":"83","author":"Mathers","year":"2005","journal-title":"Bull World Health Organ."},{"key":"B14","year":"2018","journal-title":"WHO Methods and Data Sources for Life Tables 1990-2016"},{"key":"B15","first-page":"9","volume-title":"Age Standardization of Rates: A New WHO Standard","author":"Ahmad","year":"2001"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1916","DOI":"10.1161\/CIRCULATIONAHA.115.018931","article-title":"Trends in mortality from ischemic heart disease and cerebrovascular disease in Europe: 1980 to 2009","volume":"133","author":"Hartley","year":"2016","journal-title":"Circulation."},{"key":"B17","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1007\/s12471-020-01419-9","article-title":"Transcatheter aortic valve implantation: first choice for aortic stenosis?","volume":"28","author":"den Heijer","year":"2020","journal-title":"Neth Heart J."},{"key":"B18","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1093\/eurheartj\/ehaa048","article-title":"GARY-the largest registry of aortic stenosis treatment worldwide","volume":"41","author":"Hamm","year":"2020","journal-title":"Eur Heart J."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.4244\/EIJY15M09_11","article-title":"Transcatheter aortic valve implantation (TAVI) in Germany 2008-2014: on its way to standard therapy for aortic valve stenosis in the elderly?","volume":"11","author":"Eggebrecht","year":"2016","journal-title":"EuroIntervention."},{"key":"B20","doi-asserted-by":"publisher","first-page":"126","DOI":"10.15836\/ccar.2015.126","article-title":"Aortic valve diseases in croatia in 2014 and their treatment","volume":"10","author":"Mirat","year":"2020","journal-title":"Cardiologia Croatica."},{"key":"B21","doi-asserted-by":"publisher","first-page":"18","DOI":"10.5937\/siks1501018K","article-title":"Most relevant complications of transcatheter aortic valve implantation related to the site of implantation: results of Slovenian national registry","volume":"34","author":"Kogoj","year":"2015","journal-title":"Srce i krvni sudovi."},{"key":"B22","unstructured":"CardiologyESo\n          Valve for Life Initiative in Poland: ESC2020"},{"key":"B23","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1016\/j.repce.2013.02.012","article-title":"Position statement on transcatheter aortic valve implantation in Portugal","volume":"32","author":"Campante Teles","year":"2013","journal-title":"Rev Port Cardiol."},{"key":"B24","unstructured":"AbrahaI\n            ChiarollaE\n            CorioM\n            GillespieF\n            MiglioreA\n            CerboM\n          Rapid Assessment of Other (Non-Pharmaceuticals) Health Technologies Using the HTA Core Model for Rapid Relative Effectiveness Assessment: EUnetHTA Project ID: OTCA062018"},{"key":"B25","doi-asserted-by":"publisher","first-page":"2497","DOI":"10.1161\/01.CIR.101.21.2497","article-title":"New insights into the progression of aortic stenosis: implications for secondary prevention","volume":"101","author":"Palta","year":"2000","journal-title":"Circulation."},{"key":"B26","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1007\/s11936-018-0651-x","article-title":"Sex-specific considerations in women with aortic stenosis and outcomes after transcatheter aortic valve replacement","volume":"20","author":"Mihos","year":"2018","journal-title":"Curr Treat Options Cardiovasc Med."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1213","DOI":"10.1253\/circj.CJ-16-1244","article-title":"Sex differences in severe aortic stenosis- clinical presentation and mortality","volume":"81","author":"Toyofuku","year":"2017","journal-title":"Circ J."},{"key":"B28","doi-asserted-by":"publisher","first-page":"137","DOI":"10.15420\/icr.2019.07.R1","article-title":"Sex and transcatheter aortic valve implantation: impact of female sex on clinical outcomes","volume":"14","author":"Laricchia","year":"2019","journal-title":"Interv Cardiol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1016\/j.jtcvs.2013.05.039","article-title":"Different impact of sex on baseline characteristics and major periprocedural outcomes of transcatheter and surgical aortic valve interventions: results of the multicenter Italian OBSERVANT registry","volume":"147","author":"Onorati","year":"2014","journal-title":"J Thorac Cardiovasc Surg."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1692","DOI":"10.1016\/j.amjcard.2016.08.049","article-title":"Comparison in men versus women of co-morbidities, complications, and outcomes after transcatheter aortic valve implantation for severe aortic stenosis","volume":"118","author":"Gaglia MA","year":"2016","journal-title":"Am J Cardiol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1136\/heartjnl-2014-307020","article-title":"The modern epidemiology of heart valve disease","volume":"102","author":"Coffey","year":"2016","journal-title":"Heart."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.748137\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T15:36:10Z","timestamp":1634139370000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.748137\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,11]]},"references-count":31,"alternative-id":["10.3389\/fcvm.2021.748137"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.748137","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,11]]},"article-number":"748137"}}