OBJECTIVES: Although risk factors for aortic (valve) stenosis (AS) are well understood, data on factors associated with specific severities are poorly described. This study aimed to compare age, sex and documented diagnoses of mild, moderate and severe AS patients.

METHODS: This study used electronic medical records from the Disease Analyzer database (IQVIA) containing data from general and specialist practices in Germany. The study population included patients aged ≥18 years with an initial diagnosis of AS with a documented severity stage from 62 cardiology practices in Germany between January 2013 and December 2022 (index date). The association between age, sex, and documented diagnoses within 12 months before the index date and subsequent mild, moderate or severe AS diagnoses was evaluated using multivariable logistic regression.

RESULTS: Of 31,985 patients with an initial diagnosis of AS, a severity stage was documented in 7,456 patients (2987 mild, 2938 moderate and 1531 severe AS). There was no relevant difference between the stages of AS with respect to age (75.0 years for mild vs. 76.2 years for moderate and severe stages), although the proportion of men was slightly lower in patients with severe AS (52.7%) compared to mild (55.3%) and moderate (57.2%) stages. Diagnoses of heart failure (odds ratio (OR): 1.67; 95%CI: 1.41-1.97) and chronic ischemic heart disease (OR: 1.51; 95%CI: 1.31-1.73) were strongly associated with a diagnosis of severe AS, whereas rheumatic tricuspid valve disease (OR: 1.39; 95%CI: 1.15-1.69), hypertensive heart disease (OR: 1.34; 95%CI: 1.12-1.61), and essential hypertension (OR: 1.32; 95%CI: 1.20-1.45) were associated with a diagnosis of mild AS.

CONCLUSIONS: Some significant differences were observed in the clinical history of patients diagnosed with mild and severe stages of AS. Knowledge of these differences may help to better classify severe stages in the epidemiologic research as well as in the support of AS patients.