Open access

Research Article

14 January 2019

Use of echocardiograms in the Medicare population: a diagnostic tool in the fight against severe aortic stenosis

Authors: Eugene A Grossi, Kimberly A Moore [email protected], and Candace GunnarssonAuthor Info & Affiliations

Publication: J. Comp. Eff. Res.

Volume 8, Number 4

https://doi.org/10.2217/cer-2018-0071

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Abstract

Aim: To estimate undiagnosed aortic stenosis (AS) in the Medicare population. Methods: Patients enrolled (2011–2014) were eligible. After criteria were applied, time zero was the first record of an echocardiogram (ECHO) for the ECHO-AS cohort and randomly assigned for the no-ECHO cohort. The ECHO-AS cohort was propensity matched to patients in the no-ECHO cohort, and survival analysis was performed. Results: Of the 854,493 (25%) patients who received an ECHO, 1 in 4 were diagnosed with AS. After propensity matching, the no-ECHO cohort who died, almost half (49%) had a record of a cardiovascular event prior to their death. The no-ECHO cohort had statistically significant (p = 0.003) higher risk of death than their ECHO-AS counterparts. Conclusion: In the Medicare population, patients aged 65 years or older, with increased risk factors for and symptoms common in AS patients, should be considered for diagnostic ECHOs.

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