The healthcare burden of isolated aortic valve insufficiency

Abstract To analyze and compare the differences in mortality, healthcare utilization, and costs between patients with symptomatic and asymptomatic isolated aortic insufficiency (AI). We utilized Optum United Health Care Database for US patients who had an AI claim between 2017 and 2022, with 12 mont...

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Main Authors: Ibrahim Sultan, Michael Ryan, Candace Gunnarsson, Natalie Heidrich, Prashanth Vallabhajosyula
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-87179-1
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author Ibrahim Sultan
Michael Ryan
Candace Gunnarsson
Natalie Heidrich
Prashanth Vallabhajosyula
author_facet Ibrahim Sultan
Michael Ryan
Candace Gunnarsson
Natalie Heidrich
Prashanth Vallabhajosyula
author_sort Ibrahim Sultan
collection DOAJ
description Abstract To analyze and compare the differences in mortality, healthcare utilization, and costs between patients with symptomatic and asymptomatic isolated aortic insufficiency (AI). We utilized Optum United Health Care Database for US patients who had an AI claim between 2017 and 2022, with 12 months of continuous enrollment (baseline period) prior to diagnosis. Exclusion criteria were AVR during the baseline period or a diagnosis of aortic stenosis. Patients were split into two cohorts: those with symptoms (SAI) and those without (AAI). SAI patients had ≥ 2 visits for heart failure, angina, dyspnea, or syncope at baseline. Outcomes of interest were all-cause mortality, time to home health, time to SNF, annualized healthcare utilization, and annualized costs. We used the Cox proportional model to estimate mortality and general linear models to estimate healthcare utilization and costs. Outcomes were modeled separately. Of 249,660 patients, 58.23% were symptomatic; they were generally older and sicker than the AAI cohort, and less than 1% received AVR. Almost half of AAI patients were estimated to develop symptoms within 5 years post-diagnosis. SAI outcomes were consistently higher across all measured outcomes. SAI patients have higher mortality, healthcare utilization, and costs than AAI. However, AI can progress quickly from asymptomatic to symptomatic. Early detection and timely interventions to slow the progression or address it surgically should be emphasized to limit the impact of AI.
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spelling doaj-art-7d61bd88e0894a998e5b8ea82e74e9412025-02-09T12:33:18ZengNature PortfolioScientific Reports2045-23222025-02-0115111110.1038/s41598-025-87179-1The healthcare burden of isolated aortic valve insufficiencyIbrahim Sultan0Michael Ryan1Candace Gunnarsson2Natalie Heidrich3Prashanth Vallabhajosyula4Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh and Heart and Vascular Institute, University of Pittsburgh Medical CenterMPR ConsultingGunnarsson ConsultingEdwards LifesciencesYale University School of MedicineAbstract To analyze and compare the differences in mortality, healthcare utilization, and costs between patients with symptomatic and asymptomatic isolated aortic insufficiency (AI). We utilized Optum United Health Care Database for US patients who had an AI claim between 2017 and 2022, with 12 months of continuous enrollment (baseline period) prior to diagnosis. Exclusion criteria were AVR during the baseline period or a diagnosis of aortic stenosis. Patients were split into two cohorts: those with symptoms (SAI) and those without (AAI). SAI patients had ≥ 2 visits for heart failure, angina, dyspnea, or syncope at baseline. Outcomes of interest were all-cause mortality, time to home health, time to SNF, annualized healthcare utilization, and annualized costs. We used the Cox proportional model to estimate mortality and general linear models to estimate healthcare utilization and costs. Outcomes were modeled separately. Of 249,660 patients, 58.23% were symptomatic; they were generally older and sicker than the AAI cohort, and less than 1% received AVR. Almost half of AAI patients were estimated to develop symptoms within 5 years post-diagnosis. SAI outcomes were consistently higher across all measured outcomes. SAI patients have higher mortality, healthcare utilization, and costs than AAI. However, AI can progress quickly from asymptomatic to symptomatic. Early detection and timely interventions to slow the progression or address it surgically should be emphasized to limit the impact of AI.https://doi.org/10.1038/s41598-025-87179-1Aortic valve diseaseSAVRSymptomatic AIAsymptomatic AI
spellingShingle Ibrahim Sultan
Michael Ryan
Candace Gunnarsson
Natalie Heidrich
Prashanth Vallabhajosyula
The healthcare burden of isolated aortic valve insufficiency
Scientific Reports
Aortic valve disease
SAVR
Symptomatic AI
Asymptomatic AI
title The healthcare burden of isolated aortic valve insufficiency
title_full The healthcare burden of isolated aortic valve insufficiency
title_fullStr The healthcare burden of isolated aortic valve insufficiency
title_full_unstemmed The healthcare burden of isolated aortic valve insufficiency
title_short The healthcare burden of isolated aortic valve insufficiency
title_sort healthcare burden of isolated aortic valve insufficiency
topic Aortic valve disease
SAVR
Symptomatic AI
Asymptomatic AI
url https://doi.org/10.1038/s41598-025-87179-1
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