European Heart Journal - Quality of Care and Clinical Outcomes最新文献

{"title":"Global burden of ischaemic heart disease from 2022 to 2050: projections of incidence, prevalence, deaths, and disability-adjusted life years.","authors":"Hujuan Shi, Yihang Xia, Yiran Cheng, Pengcheng Liang, Mingmei Cheng, Baoliang Zhang, Zhen Liang, Yanzhong Wang, Wanqing Xie","doi":"10.1093/ehjqcco/qcae049","DOIUrl":"10.1093/ehjqcco/qcae049","url":null,"abstract":"<p><strong>Aims: </strong>Ischaemic heart disease (IHD) has been a significant public health issue worldwide. This study aims to predict the global burden of IHD in a timely and comprehensive manner.</p><p><strong>Methods and results: </strong>Incidence, prevalence, deaths, and disability-adjusted life years (DALYs) for IHD from 1990 to 2021 were derived from the Global Burden of Disease 2021 database, and three models (linear, exponential, and Poisson regression) were used to estimate their trends over time at the global, regional, and national levels by age, sex, and country groups, with the gross domestic product per capita was applied to adjust the model. The model results revealed that the global burden of IHD is expected to increase continuously by 2050. By 2050, global IHD incidence, prevalence, deaths, and DALYs are projected to reach 67.3 million, 510 million, 16 million, and 302 million, respectively, which represents an increase of 116%, 106%, 80%, and 62%, respectively, from 2021. Moreover, the results showed that regions with lower sociodemographic index (SDI) bore a greater burden of IHD than those with higher SDI, with men having a higher burden of IHD than women. People over 70 years old account for a major part of the burden of IHD, and premature death of IHD is also becoming more serious.</p><p><strong>Conclusion: </strong>The global burden of IHD will increase further by 2050, potentially due to population ageing and economic disparities. Hence, it is necessary to strengthen the prevention of IHD and formulate targeted strategies according to different SDI regions and special populations.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"355-366"},"PeriodicalIF":4.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diverticular disease and risk of incident major adverse cardiovascular events: a nationwide matched cohort study.","authors":"Anders Forss, Wenjie Ma, Marcus Thuresson, Jiangwei Sun, Fahim Ebrahimi, David Bergman, Ola Olén, Johan Sundström, Jonas F Ludvigsson","doi":"10.1093/ehjqcco/qcae074","DOIUrl":"10.1093/ehjqcco/qcae074","url":null,"abstract":"<p><strong>Background: </strong>An increased risk of cardiovascular disease (CVD) has been reported in patients with diverticular disease (DD). However, there are knowledge gaps about specific risks of each major adverse cardiovascular event (MACE) component.</p><p><strong>Methods and results: </strong>This nationwide cohort study included Swedish adults with DD (1987-2017, N = 52 468) without previous CVD. DD was defined through ICD codes in the National Patient Register and colorectal histopathology reports from the ESPRESSO study. DD cases were matched by age, sex, calendar year, and county of residence to ≤5 population reference individuals (N = 194 525). Multivariable-adjusted hazard ratios (aHRs) for MACE up until December 2021 were calculated using stratified Cox proportional hazard models. Median age at DD diagnosis was 62 years, and 61% were females. During a median follow-up of 8.6 years, 16 147 incident MACE occurred in individuals with DD and 48 134 in reference individuals [incidence rates (IRs)= 61.4 vs. 43.8/1000 person-years], corresponding to an aHR of 1.24 (95%CI = 1.22-1.27), equivalent to one extra case of MACE for every 6 DD patients followed for 10 years. The risk was increased for ischaemic heart disease (IR = 27.9 vs. 18.6; aHR = 1.36, 95%CI = 1.32-1.40), congestive heart failure (IR = 23.2 vs. 15.8; aHR = 1.26, 95%CI = 1.22-1.31), and stroke (IR = 18.0 vs. 13.7; aHR = 1.15, 95%CI = 1.11-1.19). DD was not associated with cardiovascular mortality (IR = 18.9 vs. 15.3; aHR = 1.01, 95%CI = 0.98-1.05). Results remained robust in sibling-controlled analyses.</p><p><strong>Conclusions: </strong>Patients with DD had a 24% increased risk of MACE compared with reference individuals, but no increased cardiovascular mortality. Future research should confirm these data and examine underlying mechanisms and shared risk factors between DD and CVD.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"415-423"},"PeriodicalIF":4.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of cardiovascular disease attributable to metabolic risks in 204 countries and territories from 1990 to 2021.","authors":"Huimin Chen, Lu Liu, Yi Wang, Liqiong Hong, Wen Zhong, Thorsten Lehr, Nicola Luigi Bragazzi, Biao Tang, Haijiang Dai","doi":"10.1093/ehjqcco/qcae090","DOIUrl":"10.1093/ehjqcco/qcae090","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the global cardiovascular disease (CVD) burden attributable to metabolic risks in 204 countries and territories from 1990 to 2021.</p><p><strong>Methods and results: </strong>Following the methodologies used in the Global Burden of Disease Study 2021, this study analysed CVD deaths and disability-adjusted life-years (DALYs) attributable to metabolic risks by location, age, sex, and Socio-demographic Index (SDI). In 2021, metabolic risks accounted for 13.59 million CVD deaths (95% UI 12.01-15.13) and 287.17 million CVD DALYs (95% UI 254.92-316.32) globally, marking increases of 63.3% and 55.5% since 1990, respectively. Despite these increases, age-standardized mortality and DALY rates have significantly declined. The highest age-standardized rates of metabolic risks-attributable CVD mortality and DALYs were observed in Central Asia and Eastern Europe, while the lowest rates were found in High-income Asia Pacific, Australasia, and Western Europe, all of which are high SDI regions. Among the metabolic risks, high systolic blood pressure emerged as the predominant factor, contributing to the highest numbers of CVD deaths [10.38 million (95% UI 8.78-12.03)] and DALYs [14.52 million (95% UI 180.42-247.57)] in 2021, followed by high LDL cholesterol.</p><p><strong>Conclusion: </strong>Our study highlights the persistent and significant impact of metabolic risks on the global CVD burden from 1990 to 2021, emphasizing the need of designing public health strategies that align with regional healthcare capacities and demographic differences to effectively reduce these effects through enhanced international collaboration and specific policies.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"467-476"},"PeriodicalIF":4.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cardiovascular disease burden attributable to kidney dysfunction from 1990 to 2021: an age-period-cohort analysis of the Global Burden of Disease study.","authors":"Jiayang Dong, Zhiqiang Zhang, Jiayi Sun, Xinyue Yang, Wenjuan Zhang","doi":"10.1093/ehjqcco/qcae088","DOIUrl":"10.1093/ehjqcco/qcae088","url":null,"abstract":"<p><strong>Background: </strong>Kidney dysfunction (KD) poses a severe threat to human health. The aim of this study is to gain a comprehensive understanding of the trends in cardiovascular disease (CVD) burden attributable to KD, thereby providing a theoretical basis for relevant public health policies.</p><p><strong>Methods and results: </strong>This study analysed trends in the burden of CVD attributable to KD using the 2021 Global Burden of Disease data. It also examined the differences in mortality rates across various age groups, genders, and subtypes of CVD. Additionally, the age-period-cohort model combined with joinpoint regression analysis was employed to gain further insights into the changing trends and inflection points of CVD-related mortality. In 2021, the global number of deaths from CVD attributable to KD significantly increased compared to 1990. However, the global age-standardized mortality rate (ASMR) decreased in 2021. The burden of CVD due to KD was particularly heavy among the elderly. Analysis using the age-period-cohort model revealed a decline in CVD-related mortality rates, with similar trends observed for both men and women.</p><p><strong>Conclusion: </strong>This study reveals that although the ASMR for CVD due to KD is on a declining trend globally, the absolute number of deaths has significantly increased. This trend is especially pronounced among individuals aged 80 and older, males, and regions with a middle socio-demographic index. In the context of global aging, the burden of CVD related to KD is becoming increasingly substantial.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"456-466"},"PeriodicalIF":4.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The controversy between atrial fibrillation subtypes and worsening heart failure.","authors":"Amir Razaghizad, Thao Huynh, Abhinav Sharma","doi":"10.1093/ehjqcco/qcae018","DOIUrl":"10.1093/ehjqcco/qcae018","url":null,"abstract":"","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"510-511"},"PeriodicalIF":4.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and risk factors analysis of aortic aneurysm mortality in China over thirty years: based on the global burden of disease 2019 data.","authors":"Hongliang Huang, Liming Tang, Chunjiang Liu, Gan Jin","doi":"10.1093/ehjqcco/qcae084","DOIUrl":"10.1093/ehjqcco/qcae084","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to analyse the variation in mortality burden of aortic aneurysms (AAs) and explore the associated risk factors based on Global Burden of Disease (GBD) 2019 data, investigating the mortality burden of AA in China.</p><p><strong>Methods and results: </strong>Using GBD 2019 data, the mortality burden of AA in China from 1990 to 2019 was analysed. The age-period-cohort model was utilized to analyse time trends, period, and cohort effects of four attributable risk factors of AA by age. In 2019, the total number of AA deaths in China increased by 136.1% compared to 1990, while the age-standardized mortality rate (ASMR) decreased by 6.8%. Male deaths and ASMR were higher than those of females, and ASMR increased with age. Whether viewed overall [average annual percent change (AAPC): -0.261, 95% confidence interval (CI): -0.383 to -0.138] or by sex (female AAPC: -0.812, 95% CI: -0.977 to -0.646; male AAPC: -0.011, 95% CI: -0.183-0.162), the ASMR for AA in China has shown a declining trend since 1990. Attributable risk factors such as high blood pressure, a diet high in sodium, smoking, and lead exposure increase AA mortality with age. Smoking mortality peaks between ages 80 and 85. The cyclical effect of high blood pressure on AA mortality significantly increases, while the cyclical effects of the other three risk factors decrease. For the population born after 1940, the cohort effect of high systolic blood pressure (SBP), a diet high in sodium, and smoking increased, while the cohort effect of lead exposure decreased. The local drift values of high SBP, a diet high in sodium, and smoking decreased, while the local drift value of lead exposure increased. High SBP was identified as the most significant attributable risk factor for AA mortality burden among both males and females, and smoking was another major attributable risk factor, particularly in males.</p><p><strong>Conclusion: </strong>From 1990 to 2019, fatality due to AA in China increased notably, but the ASMR showed a decreasing trend. The mortality rate of AA was influenced by age, sex, and attributable risk factors, with elderly male smokers carrying a heavy burden of death. Moreover, tobacco control and treatment of hypertension should be strengthened to reduce the burden and its impact on AA.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"445-455"},"PeriodicalIF":4.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of five different risk models in primary prevention guidelines.","authors":"Maneesh Sud, Atul Sivaswamy, Peter C Austin, Husam Abdel-Qadir, Todd J Anderson, David M J Naimark, Douglas S Lee, Idan Roifman, George Thanassoulis, Karen Tu, Harindra C Wijeysundera, Dennis T Ko","doi":"10.1093/ehjqcco/qcae034","DOIUrl":"10.1093/ehjqcco/qcae034","url":null,"abstract":"<p><strong>Background: </strong>A lack of consensus exists across guidelines as to which risk model should be used for the primary prevention of cardiovascular disease (CVD). Our objective was to determine potential improvements in the number needed to treat (NNT) and number of events prevented (NEP) using different risk models in patients eligible for risk stratification.</p><p><strong>Methods and results: </strong>A retrospective observational cohort was assembled from primary care patients in Ontario, Canada, between 1 January 2010 and 31 December 2014 and followed for up to 5 years. Risk estimation was undertaken in patients 40-75 years of age, without CVD, diabetes, or chronic kidney disease using the Framingham Risk Score (FRS), the Pooled Cohort Equations (PCEs), a recalibrated FRS (R-FRS), the Systematic Coronary Risk Evaluation 2 (SCORE2), and the low-risk region recalibrated SCORE2 (LR-SCORE2). The cohort consisted of 47 399 patients (59% women, mean age 54 years). The NNT with statins was lowest for the SCORE2 at 40, followed by the LR-SCORE2 at 41, the R-FRS at 43, the PCEs at 55, and the FRS at 65. Models that selected for individuals with a lower NNT recommended statins to fewer, but higher-risk patients. For instance, the SCORE2 recommended statins to 7.9% of patients (5-year CVD incidence 5.92%). The FRS, however, recommended statins to 34.6% of patients (5-year CVD incidence 4.01%). Accordingly, the NEP was highest for the FRS at 406 and lowest for the SCORE2 at 156.</p><p><strong>Conclusions: </strong>Newer models such as the SCORE2 may improve statin allocation to higher-risk groups with a lower NNT but prevent fewer events at the population level.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"388-396"},"PeriodicalIF":4.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140908679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic status and cardiovascular mortality in over 170 000 cancer survivors.","authors":"Mi-Hyang Jung, Yun-Seok Choi, Sang-Wook Yi, Sang Joon An, Jee-Jeon Yi, Sang-Hyun Ihm, So-Young Lee, Jong-Chan Youn, Woo-Baek Chung, Hae Ok Jung, Ho-Joong Youn","doi":"10.1093/ehjqcco/qcae055","DOIUrl":"10.1093/ehjqcco/qcae055","url":null,"abstract":"<p><strong>Aims: </strong>Cardiovascular health is acknowledged as a crucial concern among cancer survivors. Socioeconomic status (SES) is an essential but often neglected risk factor for cardiovascular disease (CVD). We conducted this study to identify the relationship between SES and CVD mortality in cancer survivors.</p><p><strong>Methods and results: </strong>Using the National Health Insurance Service-National Health Examinee database, we identified cancer survivors diagnosed and surviving beyond 5 years post-diagnosis. SES was assessed based on insurance premiums and classified into five groups. The primary outcome was overall CVD mortality. This study analysed 170 555 individuals (mean age 60.7 ± 11.9 years, 57.8% female). A gradual increase in risk was observed across SES groups: adjusted hazard ratios (95% confidence intervals) for overall CVD mortality were 1.15 (1.04-1.26), 1.28 (1.15-1.44), 1.31 (1.18-1.46), and 2.13 (1.30-3.49) for the second, third, and fourth quartile, and medical aid group (the lowest SES group) compared to the highest SES group, respectively (P for trend < 0.001). The lowest SES group with hypertension exhibited a 3.4-fold higher risk of CVD mortality compared to the highest SES group without hypertension. Interaction analyses revealed that low SES synergistically interacts with hypertension, heightening the risk of CVD mortality (synergy index 1.62).</p><p><strong>Conclusion: </strong>This study demonstrates a significant correlation between low SES and increased CVD mortality among cancer survivors. Particularly, the lowest SES group, when combined with hypertension, significantly escalates CVD mortality. Our findings underscore the critical importance of recognizing SES as a significant risk factor for CVD mortality in this population of cancer survivors.</p><p><strong>Lay summary: </strong>Our population-based cohort study, involving over 170 000 cancer survivors, demonstrates a significant association between socioeconomic status (SES) and cardiovascular disease (CVD) mortality.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"406-414"},"PeriodicalIF":4.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden of heart failure and its underlying causes in 204 countries and territories, 1990-2021.","authors":"Qin-Fen Chen, Lifen Chen, Christos S Katsouras, Chenyang Liu, Jingjing Shi, Dongjie Liang, Guangze Xiang, Han Zhu, Hetong Liao, Weihong Lin, Xi Zhou, Xiao-Dong Zhou","doi":"10.1093/ehjqcco/qcae110","DOIUrl":"10.1093/ehjqcco/qcae110","url":null,"abstract":"<p><strong>Background and aims: </strong>Heart failure (HF) presents a significant global health challenge due to its rising prevalence and impact on disability. This study aims to comprehensively analyse the global burden of HF and its underlying causes.</p><p><strong>Methods and results: </strong>Using data from the Global Burden of Disease Study 2021, we analysed the prevalence and years lived with disability (YLD) of HF, examining its implications across diverse demographics and geographic regions. In 2021, approximately 55.5 million [95% uncertainty interval (UI) 49.0-63.8] people worldwide were affected by HF, a significant increase from 25.4 million (95% UI 22.3-29.2) in 1990. The age-standardized prevalence rate per 100 000 people was 676.7 (95% UI 598.7-776.8) overall, with males experiencing a higher rate at 760.8 (95% UI 673.2-874.7) compared to females at 604.0 (95% UI 535.0-692.3). The age-standardized prevalence YLD rates increased by 5.5% [95% confidence interval (CI) 2.7-8.5] and 5.9% (95% CI 2.9-9.0) during this period. Ischaemic heart disease emerged as the primary cause of HF, with an age-standardized prevalence rate of 228.3 (95% UI 118.2-279.6), followed by hypertensive heart disease at 148.3 (95% UI 117.3-186.3), and cardiomyopathy/myocarditis at 62.0 (95% UI 51.2-73.2). Noteworthy, countries in the high socio-demographic index (SDI) quintile exhibited higher HF prevalence rates but maintained stable trends. In contrast, countries in lower SDI quintiles, while initially experiencing lower prevalence rates, showed increased age-standardized HF prevalence and YLD rates over the same period.</p><p><strong>Conclusion: </strong>HF emerges as a significant and growing public health challenge globally, influenced by distinct socioeconomic gradients.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"493-509"},"PeriodicalIF":4.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of population screening for aortic stenosis.","authors":"Pouya Motazedian, Graeme Prosperi-Porta, Benjamin Hibbert, Hawre Jalal, Marino Labinaz, Ian G Burwash, Omar Abdel-Razek, Pietro Di Santo, Trevor Simard, George Wells, Doug Coyle","doi":"10.1093/ehjqcco/qcae043","DOIUrl":"10.1093/ehjqcco/qcae043","url":null,"abstract":"<p><strong>Aims: </strong>Aortic stenosis (AS) is a progressive disease predominantly affecting elderly patients that carries significant morbidity and mortality without aortic valve replacement, the only proven treatment. Our objective was to determine the cost-effectiveness of AS screening using transthoracic echocardiography (TTE) in a geriatric population from the perspective of the publicly funded healthcare system in Canada.</p><p><strong>Methods and results: </strong>Markov models estimating the cost-effectiveness ratio (ICER) for AS screening with a one-time TTE were developed. The model included diagnosed and undiagnosed AS health states, hospitalizations, transcatheter aortic valve replacement (TAVR), and post-TAVR health states. Primary analysis included screening at 70 and 80 years of age with intervention at symptom onset, with scenario analysis included for early intervention at the time of severe asymptomatic AS diagnosis. Monte Carlo simulation of 5000 replications was completed with a lifetime horizon and a 1.5% discount for costs and outcomes.Screening for AS at the age of 70 years was associated with an ICER of $156 722, and screening at 80 years of age was associated with an ICER of $28 005, suggesting that screening at 80 years of age is cost-effective when willingness-to-pay per QALY is $50 000. Scenario analysis with early intervention was not cost-effective, with an ICER of $142 157 at 70 years and $124 651 at 80 years.</p><p><strong>Conclusion: </strong>Screening for AS at 80 years of age with a one-time TTE, in a Canadian population, improves quality of life and is cost-effective in a publicly funded healthcare system providing, TAVR is reserved for symptomatic patients.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"378-387"},"PeriodicalIF":4.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}