Abstract 15269: Racial and Income Disparities and Trends in the Use of Bioprosthetic Valves for Aortic Valve Replacements
Introduction: The use of bioprosthetic valves (BAVR) for aortic valve replacements (AVR) has been on the rise and being placed in increasingly younger patients. We sought to determine usage trends of BAVR versus mechanical (MAVR) prosthesis for AVRs, and to examine whether race and income level correlate with valve selection.
Hypothesis: The use of bioprosthetic over mechanical aortic valves has been increasing and there is a correlation between the type of valve used and both income and race.
Methods: The Nationwide Inpatient Sample (NIS) from 2000 to 2010 was queried to identify all patients who had an isolated BAVR or MAVR. The trend in the rates of BAVR selection was determined according to sex, age, race, and income level.
Results: From the 86.6 million patient discharges, 70,012 isolated aortic valves were implanted. 51.8% were BAVR and 59.8% were implanted into males. The proportion of patients receiving BAVR increased annually from 32.7% in 2000 to 63.6% in 2009. By 2010, 69.8% of 60-89 year-olds and 42.1% of 30-59 year-olds received BAVRs. Starting in 2005, more than half of all isolated aortic valves implanted were bioprosthetic. There was also a significant positive correlation between higher incomes and the likelihood of getting a BAVR, ranging from 55.9% for the lowest quartile to 68.3% for the highest quartile (p<0.001). Additionally, whites (64.0%) were more likely than blacks (53.2%; p<0.001) and Hispanics (56.8%; p<0.001) to get BAVR.
Conclusions: The rate of BAVRs has been increasing and correlates positively with age and income level. BAVRs were also more common in whites compared to blacks and Hispanics. Further studies are needed to understand the influence of socioeconomic status and race on the type of valve chosen for AVR.
Author Disclosures: P.H. Lee: None. A. Kilic: None. B. Whitson: None. J. Crestanello: None. R. Higgins: None.
- © 2014 by American Heart Association, Inc.