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

MedStar author(s):
Citation: Catheterization & Cardiovascular Interventions. 85(4):640-7, 2015 Mar.PMID: 24782407Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal Article | Observational StudySubject headings: *African Americans | *Aortic Valve | *Aortic Valve Stenosis/th [Therapy] | *Cardiac Catheterization | *European Continental Ancestry Group | *Health Status Disparities | *Heart Valve Prosthesis Implantation | Aged | Aged, 80 and over | Aortic Valve Stenosis/di [Diagnosis] | Aortic Valve Stenosis/eh [Ethnology] | Aortic Valve Stenosis/mo [Mortality] | Aortic Valve Stenosis/pp [Physiopathology] | Aortic Valve/pp [Physiopathology] | Cardiac Catheterization/ae [Adverse Effects] | Cardiac Catheterization/mo [Mortality] | Cardiac Catheterization/mt [Methods] | Female | Heart Valve Prosthesis Implantation/ae [Adverse Effects] | Heart Valve Prosthesis Implantation/mo [Mortality] | Heart Valve Prosthesis Implantation/mt [Methods] | Hemodynamics | Humans | Kaplan-Meier Estimate | Male | Retrospective Studies | Risk Factors | Severity of Illness Index | Treatment Outcome | United States/ep [Epidemiology]Local holdings: Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006ISSN:
  • 1522-726X
Name of journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & InterventionsAbstract: 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.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.Copyright � 2014 Wiley Periodicals, Inc.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.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).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).All authors: Barbash IM, Ben-Dor I, Magalhaes MA, Minha S, Okubagzi PG, Pendyala LK, Pichard AD, Satler LF, Torguson R, Waksman RDigital Object Identifier: Date added to catalog: 2016-01-15
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available 24782407

Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006

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.

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.Copyright � 2014 Wiley Periodicals, Inc.

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.

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).

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).

English

Powered by Koha