Expert review of cardiovascular therapy · 2025
Sex and race/ethnicity disparities on in-hospital outcomes in patients with severe aortic stenosis undergoing TAVR.
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Diaz-Arocutipa Carlos, Salguero Rafael, Puerto Elena, Martín-Asenjo Roberto, Vicent Lourdes
Аннотация
BACKGROUND: We assessed the sex and racial/ethnic disparities on in-hospital outcomes in patients undergoing transcatheter aortic valve replacement (TAVR).
RESEARCH DESIGN AND METHODS: This retrospective study analyzed TAVR procedures performed during 2016-2019. Data from the National Inpatient Sample database identified 155,610 patients who underwent TAVR. Outcomes included in-hospital mortality, stroke, major bleeding, and other complications, assessed separately by sex and race/ethnicity (White, Black, and Hispanic). Logistic regression was used to estimate odds ratio (OR) with its 95% confidence interval (CI).
RESULTS: Women had higher odds of in-hospital mortality (OR 1.33, 95% CI 1.07-1.64), bleeding, and vascular complications, but lower odds of pacemaker implantation and renal replacement therapy compared with men. Hispanic patients had increased mortality (OR 1.86, 95% CI 1.26-2.75) and black patients had increased odds of stroke (OR 2.06, 95% CI 1.24-3.44). Subgroup analysis showed that Hispanic women had the highest mortality odds (OR 2.42, 95% CI 1.46-4.01).
CONCLUSIONS: There are significant sex and racial/ethnic disparities in TAVR outcomes, particularly among minority women. Women had a higher odds of mortality, major bleeding, and vascular complications compared to men. Racial disparities were also seen, with Hispanic patients having an increased odds of mortality and black patients having an increased odds of stroke.
RESEARCH DESIGN AND METHODS: This retrospective study analyzed TAVR procedures performed during 2016-2019. Data from the National Inpatient Sample database identified 155,610 patients who underwent TAVR. Outcomes included in-hospital mortality, stroke, major bleeding, and other complications, assessed separately by sex and race/ethnicity (White, Black, and Hispanic). Logistic regression was used to estimate odds ratio (OR) with its 95% confidence interval (CI).
RESULTS: Women had higher odds of in-hospital mortality (OR 1.33, 95% CI 1.07-1.64), bleeding, and vascular complications, but lower odds of pacemaker implantation and renal replacement therapy compared with men. Hispanic patients had increased mortality (OR 1.86, 95% CI 1.26-2.75) and black patients had increased odds of stroke (OR 2.06, 95% CI 1.24-3.44). Subgroup analysis showed that Hispanic women had the highest mortality odds (OR 2.42, 95% CI 1.46-4.01).
CONCLUSIONS: There are significant sex and racial/ethnic disparities in TAVR outcomes, particularly among minority women. Women had a higher odds of mortality, major bleeding, and vascular complications compared to men. Racial disparities were also seen, with Hispanic patients having an increased odds of mortality and black patients having an increased odds of stroke.