Literature DB >> 24782407

Outcome comparison of African-American and Caucasian patients with severe aortic stenosis subjected to transcatheter aortic valve replacement: a single-center experience.

Sa'ar Minha1, Israel M Barbash, Marco A Magalhaes, Itsik Ben-Dor, Petros G Okubagzi, Lakshmana K Pendyala, Lowell F Satler, Augusto D Pichard, Rebecca Torguson, Ron Waksman.   

Abstract

OBJECTIVE: This study aimed to report the outcomes of African Americans (AAs) in the US undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS).
BACKGROUND: Compared to Caucasians, AAs are reported to have poorer outcomes from most cardiovascular diseases, including high complication rates after surgical aortic valve replacement. The outcomes of AAs undergoing TAVR are not well established.
METHODS: Consecutive patients who underwent TAVR were included in this analysis. Patients' baseline characteristics, procedural data, in-hospital- and long-term outcomes were recorded and a comparison was performed between the AA and Caucasian cohorts.
RESULTS: In a cohort of 469 consecutive patients, 51 (10.8%) were AA and 345 (74.5%) were Caucasian. The remaining patients (n = 73; 15.3%) self-reported their race as "unknown" or were from other races. Most baseline characteristics were similar between the two groups except for less men (33.3 vs. 50.1%; P = 0.016), a lower mean left ventricular ejection fraction (48.85 ± 16.35 vs. 53.24 ± 13.41%; P = 0.04) and lower rates of atrial fibrillation in AAs (15.7 vs.45.4%; P < 0.001). TAVR procedures in AAs were less frequently performed as part of a clinical trial (60.8 vs. 76.8%; P = 0.014). Most procedural and periprocedural outcome parameters were similar save for a higher rate of hemodynamic instability and postoperative need for intubation in AAs (10.4 vs. 2.5%; P = 0.018 and 29.4 vs. 16.9%; P = 0.03, respectively). This did not translate into a difference in mortality between AAs and Caucasians (30-day mortality 9.8 vs. 9.9%; P = 0.99; 1-year mortality 19.6 vs. 24.3%; P = 0.458, respectively).
CONCLUSION: Unlike with other cardiovascular interventions, this study demonstrates that AA patients referred for TAVR shared similar risks and outcomes when compared to a Caucasian population.
© 2014 Wiley Periodicals, Inc.

Entities:  

Keywords:  aortic stenosis; racial disparities; transcatheter aortic valve replacement

Mesh:

Year:  2014        PMID: 24782407     DOI: 10.1002/ccd.25535

Source DB:  PubMed          Journal:  Catheter Cardiovasc Interv        ISSN: 1522-1946            Impact factor:   2.692


  5 in total

Review 1.  A review of racial disparities in transcatheter aortic valve replacement (TAVR): accessibility, referrals and implantation.

Authors:  Tamunoinemi Bob-Manuel; Arindam Sharma; Amit Nanda; Devarshi Ardeshna; William Paul Skelton; Rami N Khouzam
Journal:  Ann Transl Med       Date:  2018-01

2.  Socioeconomic and Racial Disparities: a Case-Control Study of Patients Receiving Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis.

Authors:  Anna Sleder; Shiloh Tackett; Matthew Cerasale; Chetan Mittal; Iyad Isseh; Ryhm Radjef; Andrew Taylor; Rashad Farha; Oleksandra Lupak; Dana Larkin; Lois Lamerato; George Divine; Kimberlydawn Wisdom; Kimberly Baker-Genaw; William O'Neill
Journal:  J Racial Ethn Health Disparities       Date:  2016-12-30

3.  Racial/Ethnic Disparities in Patients Undergoing Transcatheter Aortic Valve Replacement: Insights from the Healthcare Cost and Utilization Project's National Inpatient Sample.

Authors:  Dagmar F Hernandez-Suarez; Sagar Ranka; Pedro Villablanca; Nicole Yordan-Lopez; Lorena González-Sepúlveda; Jose Wiley; Cristina Sanina; Abiel Roche-Lima; Brenda G Nieves-Rodriguez; Stacey Thomas; Pedro Cox-Alomar; Angel Lopez-Candales; Harish Ramakrishna
Journal:  Cardiovasc Revasc Med       Date:  2019-04-09

4.  Racial Disparities in the Utilization and Outcomes of Structural Heart Disease Interventions in the United States.

Authors:  Mohamad Alkhouli; Fahad Alqahtani; David R Holmes; Chalak Berzingi
Journal:  J Am Heart Assoc       Date:  2019-07-18       Impact factor: 5.501

5.  Racial Differences in the Use of Aortic Valve Replacement for Treatment of Symptomatic Severe Aortic Valve Stenosis in the Transcatheter Aortic Valve Replacement Era.

Authors:  J Matthew Brennan; Martin B Leon; Paige Sheridan; Isabel J Boero; Qinyu Chen; Angela Lowenstern; Vinod Thourani; Sreekanth Vemulapalli; Kevin Thomas; Tracy Y Wang; Eric D Peterson
Journal:  J Am Heart Assoc       Date:  2020-08-11       Impact factor: 5.501

  5 in total

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