Abstract 16323: Racial Differences in Outcomes of Transcatheter Aortic Valve Replacement: Insights From a National Database
Introduction: African-American (AA) patients have poorer outcomes as compared to Caucasian patients for many cardiovascular diseases. Whether such racial differences exist in outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) is not clearly established.
Methods: We analyzed the National Inpatient Sample (NIS) database and compared clinical characteristics and in-hospital outcomes for AA vs. Caucasian patients who underwent TAVR in 2011- 2012.
Results: The study population included 308 (3.7%) AA and 6,978 (96.3%) Caucasian patients. At baseline, AA patients were younger (mean age 80.0 ± 9.3 vs. 81.3 ± 9.0 years, p=0.01), more likely to be female (62.7% vs. 47.7%, p<0.001) or have hypertension (90.3% vs. 79.5%, p <0.001), obesity (17.6% vs. 12.1%, p=0.01) or renal failure (50.2% vs. 34.6%, p <0.001). (Table 1) After adjusting for clinical and demographic features using a multivariable regression model, all-cause in-hospital mortality following TAVR was similar in AA and Caucasians (3.2% vs. 4.7%; OR:0.8, 95% CI: 0.4-1.5; p=0.5). (Table 2) AA patients had a higher frequency of stroke (OR:3.7, 95% CI: 1.8-7.3; p<0.001) and vascular complications (OR:1.5, 95% CI:1.2-2.0; p=0.001) after TAVR but a lower frequency of PPM implantation during index hospitalization (OR: 0.5, 95% CI: 0.3-0.9; p=0.02). There was no difference in mean lengths of hospital stay (8.1 ± 5.7 vs. 8.5 ± 7.0 days, p=0.5).
Conclusions: AA constituted a small minority among patients undergoing TAVR. When compared to Caucasian patients, they had more co-morbidities despite being younger. While in-hospital mortality was similar, AA patients had higher rates of post TAVR complications.
Author Disclosures: N. Bhatia: None. S. Agrawal: None. M. Pahuja: None. L. Garg: None. D. Mohananey: None. M. Durkin: None. M. Agarwal: None. R.G. Soni: None. J. Shirani: None.
- © 2016 by American Heart Association, Inc.