Abstract 4285: Lower Prevalence of Congenital Bicuspid Aortic Valves and Calcific Aortic Stenosis in Black Compared to White Patients
Predictors of aortic valve disease (AVD) include clinical and genetic factors including the presence of familial bicuspid aortic valve (BAV). Whether race affects the prevalence of AVD including BAV is unknown. Through the Cleveland Clinic Cardiovascular Institutional Registry from 1993–2007, a total of 40,419 pts underwent aortic and/or mitral valve surgery or coronary bypass grafting. Of these, 38,366 were white and 2,053 were black. From the total cohort, 12,714 pts undergoing aortic valve surgery were identified for analysis. Prospective evaluation of aortic valves was coded identifying etiology and morphology by surgical and pathologic inspection. At baseline, compared to white pts, blacks were younger, more often female, had higher body mass index, and a greater prevalence of hypertension, diabetes, tobacco use, and renal disease. The prevalence of BAV was considerably lower in blacks versus whites, as was the presence of aortic stenosis and pathologically-determined aortic valve calcification, while the rates of rheumatic disease were similar (Table⇓). In this large surgical series, etiology and valve morphology differed among blacks and whites. Despite an adverse cardiovascular risk profile, blacks have a significantly lower prevalence of calcific AVD compared to whites, whereas congenital BAV disease appears much less prevalent in blacks. Our findings offer early insight into the influence of race/ethnicity on the development of calcific AVD and BAV.