Alerting trends in epidemiology for non-rheumatic degenerative mitral valve disease, 1990-2019: An age-period-cohort analysis for the Global Burden of Disease Study 2019

Zeye Liu; Peijian Wei; Hong Jiang; Fengwen Zhang; Wenbin Ouyang; Shouzheng Wang; Fang Fang; Xiangbin Pan

doi:10.1016/j.ijcard.2023.131561

Alerting trends in epidemiology for non-rheumatic degenerative mitral valve disease, 1990-2019: An age-period-cohort analysis for the Global Burden of Disease Study 2019

Int J Cardiol. 2024 Jan 15:395:131561. doi: 10.1016/j.ijcard.2023.131561. Epub 2023 Oct 31.

Authors

Zeye Liu¹, Peijian Wei¹, Hong Jiang¹, Fengwen Zhang¹, Wenbin Ouyang¹, Shouzheng Wang¹, Fang Fang¹, Xiangbin Pan²

Affiliations

¹ Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
² Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. Electronic address: panxiangbin@fuwaihospital.org.

PMID: 37913964
DOI: 10.1016/j.ijcard.2023.131561

Abstract

Background: The global and national burden of rheumatic mitral valve disease (MVD) has been well studied and estimated before. However, little is known about non-rheumatic degenerative MVD. Therefore, this study aimed to assess the trends in non-rheumatic degenerative MVD (NRDMVD) epidemiology, with an emphasis on NRDMVD mortality, leading risk factors, and their associations with age, period, and birth cohort.

Methods: Using the data derived from the Global Burden of Disease Study 2019, including prevalence, mortality, and disability-adjusted life years, we analyzed the burden of NRDMVD and the detailed trends of NRDMVD mortality over the past 30 years in 204 countries and territories by implementing the age-period-cohort framework.

Results: Globally, the number of deaths due to NRDMVD increased from 5695.89 (95% uncertainty interval [UI]: 5405.19 to 5895.4) × 1000 in 1990 to 9137.79 (95% UI: 8395.68 to 9743.55) × 1000 in 2019. The all-age mortality rate increased from 106.47 (95% UI: 101.03 to 110.2) per 100,000 to 118.1 (95% UI: 108.51 to 125.93) per 100,000, whereas the age-standardized mortality rate decreased from 170.45 (95% UI: 159.61 to 176.94) per 100,000 to 117.95 (95% UI: 107.83 to 125.92) per 100,000. The estimated net drift of mortality per year was -1.1% (95% confidence interval: -1.17 to -1.04). The risk of death due to NRDMVD increased with age, reaching its peak after 85 years old globally. Despite female patients being associated with lower local drift than male patients, no significant gender differences were observed in the age effect across countries and regions for all sociodemographic index (SDI) levels, except low-SDI regions.

Conclusions: We estimated the global disease prevalence of and mortality due to NRDMVD over approximately a 30-year period. The health-related burden of NRDMVD has declined worldwide; however, the condition persisted in low-SDI regions. Moreover, higher attention should be paid to female patients.

Keywords: Age-period-cohort; Global burden of disease; Mortality; Non-rheumatic degenerative mitral valve disease; Risk factor.

MeSH terms

Aged, 80 and over
Cohort Studies
Female
Global Burden of Disease*
Global Health
Humans
Incidence
Male
Mitral Valve*
Prevalence
Quality-Adjusted Life Years
Risk Factors
Sex Distribution