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PhD project: Development in diagnosis, treatment and prognosis of valvular heart disease in Denmark in 2002-2016 focusing on socioeconomic differences

Valvular heart disease is a growing public health issue and is an increasing burden for the health sector. Valvular heart disease is divided in stenosis and insufficiencies and the disease primarily affects the aortic and mitral valve. In the industrialized countries the disease is most commonly caused by degeneration, primarily in elderly patients, and despite the fact that it is not as common as ischemic heart disease and heart failure, the burden of disease is often underestimated. Valvular heart disease causes significant functional impairments, early death, loss of good years of life and impaired quality of life. Untreated or late diagnosed valvular heart disease increases the risk of developing chronic heart failure. Valvular heart disease is often treated with an operation, where the affected valve is repaired or replaced and over the last decades significant improvements in treatment and prognosis have been observed for patients with valvular heart disease.

Purpose

This project will investigate the epidemiology of valvular heart disease in Denmark within the last 15 years and the development in diagnosis, treatment and prognosis with particular focus on demographic and socioeconomic differences. Our hypothesis is that patients from lower social classes are diagnosed later and treated less, which may lead to a worse prognosis, while no social gradient is expected in the occurrence of valvular heart disease

Methods

In Denmark, we have a unique opportunity to link nationwide registries using the unique CPR number, thus providing information about morbidity and use of healthcare. Danish Heart Registry is a nationwide clinical database that identifies all invasive cardiological and cardiovascular procedures. The National Patient Register (NPR) contains information from 1978 on all patient contacts with the Danish hospitals, and since 1995 all outpatient contacts and emergency contacts are also recorded. From 1995, the Danish Medicines Register contains information about all collected prescriptions from pharmacies in Denmark. From registers in Statistics Denmark, information about social and socio-economic conditions will be obtained.

Funding

The Health Foundation.

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