Global, Regional, and National Burden of Non-Rheumatic Calcified Aortic Valve Disease from 1990 to 2021 and Projections to 2050

Backgroundnon-rheumatic calcific aortic valve disease (nrCAVD) is a valvular disease characterized by progressive calcification of the aortic valve that can lead to progressive left heart failure and death. This study reports on the global burden of CAVD, utilizing all available data and using the Global Burden of Disease (GBD) study methodology to understand the epidemiology of this widely prevalent disease. MethodsPrior to the current effort, the burden of CAVD was included in GBD as a non-specific contributor to "valvular heart disease" burden. In this study, CAVD was distinguished as its own cause of death and disability in GBD, producing comparable and consistent estimates of CAVD burden. We used epidemiological and vital registry data to estimate the non-fatal and fatal burden of CAVD in 204 countries and 21 territories from 1990 to 2021 using standard GBD modelling approaches. ResultsIn 2021, there were an estimated 13,320,896.13 (95% uncertainty interval [UI] 11,422,539.18 to 15,249,410.95) prevalent cases of CAVD globally. Of these, 6,018,666.77 (5,139,855.53 to 6,897,468.51) were in females (45%) and 7,302,229.37 (6,260,246.93 to 8,340,870.42) in males (55%). The age-standardised prevalence was 158.35 cases per 100 000 population (95% UI 135.92 - 181.00). Prevalence increased with age such that the highest prevalence was among individuals aged 90-94 years. In 2021, there were 142,205.00 (120,674.91 - 155,574.74) attributed to PAH globally, with an age-standardised mortality rate of 1.83 deaths from CAVD per 100 000 population (1.54 - 2.00). The burden of disease appears to be improving over time.