J Med Econ. 2026 Dec;29(1):761-771. doi: 10.1080/13696998.2026.2635880. Epub 2026 Mar 9.
ABSTRACT
OBJECTIVE: To compare mortality, healthcare utilization, and costs between patients with symptomatic and asymptomatic mixed aortic valve disease (MAVD).
METHODS: We analyzed Optum United Health Care database for US patients with aortic insufficiency (AI) claims (2017-2024) and prior/concurrent aortic stenosis (AS) claims, requiring 12 months continuous enrollment. Patients with baseline aortic valve replacement (AVR) were excluded. Symptomatic MAVD (SMAVD) was defined as ≥2 baseline visits for heart failure, angina, dyspnea, or syncope. Outcomes included mortality, time to home health/skilled nursing facility (SNF), and annualized healthcare utilization and costs, analyzed using Cox proportional hazard and general linear models.
RESULTS: Among 132,361 MAVD patients, 73.62% (n = 97,448) were symptomatic at diagnosis. Of initially asymptomatic patients, 58.94% became symptomatic within 5 years. Only 22% received AVR within 5 years. SMAVD patients had higher mortality (HR 1.48, 95% CI 1.44-1.53), home health utilization (HR 1.32, 95% CI 1.30-1.35), SNF admissions (HR 1.38, 95% CI 1.35-1.41), and $11,120 higher annual costs.
CONCLUSIONS: SMAVD patients experience significantly worse outcomes than asymptomatic patients. Early detection and timely interventions are critical to reducing MAVD’s healthcare burden.
PMID:41801137 | DOI:10.1080/13696998.2026.2635880
