TY  - BOOK
AU  - Thourani, Vinod H
TI  - Racial Disparities in the Utilization and Outcomes of TAVR: TVT Registry Report
SN  - 1936-8798
PY  - 2019///
KW  - *Aortic Valve Stenosis/su [Surgery]
KW  - *Aortic Valve/su [Surgery]
KW  - *Continental Population Groups
KW  - *Healthcare Disparities/eh [Ethnology]
KW  - *Practice Patterns, Physicians'
KW  - *Transcatheter Aortic Valve Replacement
KW  - Aged
KW  - Aged, 80 and over
KW  - Aortic Valve Stenosis/eh [Ethnology]
KW  - Aortic Valve Stenosis/mo [Mortality]
KW  - Aortic Valve Stenosis/pp [Physiopathology]
KW  - Aortic Valve/pp [Physiopathology]
KW  - Female
KW  - Hemodynamics
KW  - Hospital Mortality/eh [Ethnology]
KW  - Humans
KW  - Male
KW  - Medicare
KW  - Postoperative Complications/eh [Ethnology]
KW  - Postoperative Complications/mo [Mortality]
KW  - Postoperative Complications/th [Therapy]
KW  - Race Factors
KW  - Recovery of Function
KW  - Registries
KW  - Risk Assessment
KW  - Risk Factors
KW  - Time Factors
KW  - Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
KW  - Transcatheter Aortic Valve Replacement/mo [Mortality]
KW  - Trauma Severity Indices
KW  - Treatment Outcome
KW  - United States/ep [Epidemiology]
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N2  - BACKGROUND: Racial disparities in cardiovascular diseases are well described. Whether the racial disparities observed in surgical aortic valve replacement also exist with TAVR remains unknown; CONCLUSIONS: Racial minorities are underrepresented among patients undergoing TAVR in the United States, but their adjusted 30-day and 1-year clinical outcomes are comparable with those of white race; Copyright (c) 2019. Published by Elsevier Inc; METHODS: Patients undergoing TAVR between November 2011 and June 2016 were identified in the American College of Cardiology/Society of Thoracic Surgeons/Transcatheter Valve Therapy Registry. We described the racial distribution, and the risk-adjusted in-hospital morbidity, and mortality stratified by race. We evaluated 1-year outcomes in a subset of patients via linkage to Medicare (Centers for Medicare and Medicaid Services) claims; OBJECTIVES: This study sought to evaluate racial disparities in the performance and outcomes of transcatheter aortic valve replacement (TAVR); RESULTS: Among the 70,221 included patients, 91.3% were white, 3.8% were black, 3.4% were Hispanic, and 1.5% were of Asian/Native American/Pacific Islander race. This represented significant underrepresentation of nonwhite patients compared with their proportion of the population. After risk-adjustment, there was no difference in the rates of in-hospital mortality, myocardial infarction, stroke, major bleeding, vascular complications, or new pacemaker requirements among the 4 racial groups. Among 29,351 patients with Centers for Medicare and Medicaid Services linkage, 1-year adjusted mortality rates were similar in blacks and Hispanics compared with whites, but lower among patients of Asian/Native American/Pacific Islander race (adjusted hazard ratio: 0.71; 95% confidence interval: 0.55 to 0.92; p = 0.028). Black and Hispanic patients had more heart failure hospitalizations compared with whites (adjusted hazard ratio: 1.39; 95% confidence interval: 1.16 to 1.67; p < 0.001; and adjusted hazard ratio: 1.37; 95% confidence interval: 1.13 to 1.66; p = 0.004, respectively). These differences persisted after additional risk-adjustment for socioeconomic status
UR  - https://dx.doi.org/10.1016/j.jcin.2019.03.007
ER  -