Clinical cardiology · 2025
Outcomes of Left Atrial Appendage Occlusion in Hispanic/Latino Patients: Insights From the National Inpatient Sample.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Fleurestil Mashli, Mohan Ayush, Ergui Ian, Samaha Jacklyn, Colombo Rosario, Mitrani Raul, de Marchena Eduardo, Villablanca Pedro, Wiley Jose, Chatzizisis Yiannis S, Cox Pedro
Аннотация
BACKGROUND: Left atrial appendage occlusion (LAAO) is an established therapy for stroke prevention in non-valvular atrial fibrillation (NVAF), but outcomes in Hispanic populations remain underexplored.
OBJECTIVE: The objective of our study was to evaluate the inpatient outcomes of Hispanic patients undergoing LAAO as compared to non-Hispanic white patients.
METHODS: We conducted a retrospective cohort study using the National Inpatient Sample (NIS). From 157 434 LAAO hospitalizations identified, 133 517 were non-Hispanic white and 6814 were Hispanic/Latino. The primary outcome was in-hospital mortality.
RESULTS: Unadjusted odds in the Hispanic/Latino group were higher for mortality (OR 1.78, 95% CI 1.18-2.68, p 0.006), stroke (OR 1.64, 95% CI 1.26-2.14, p < 0.001), infectious complications (OR 3.89, 95% CI 3.03-4.99, p < 0.001), major bleeding (OR 1.22, 95% CI 1.11-1.33, p < 0.001), DVT/PE (OR 2.15, 95% CI 1.58-2.93, p < 0.001), and vascular complications (OR 1.81, 95% CI 0.53-0.93, p < 0.001). After adjusting for covariates and comorbidities, Hispanic/Latino patients had still greater odds of mortality (aOR 1.20, 95% CI 0.75-1.92, p 0.445), infectious complications (aOR 3.54, 95% CI 2.62-4.55, p < 0.001), and vascular complications (aOR 1.57, 95% CI 1.22-2.03, p < 0.001). Non-Hispanic white patients had higher adjusted odds of pericardial effusion/tamponade (aOR 0.64, 95% CI 0.52-0.95, p 0.03), while Hispanic/Latino patients also had higher adjusted odds of cardiac arrest (aOR 1.99, 95% CI 1.15-3.42, p 0.46).
CONCLUSION: Hispanic/Latino patients undergoing LAAO experience higher odds of infectious and vascular complications compared to non-Hispanic white patients. These findings highlight the need to further investigate disparities in procedural outcomes.
OBJECTIVE: The objective of our study was to evaluate the inpatient outcomes of Hispanic patients undergoing LAAO as compared to non-Hispanic white patients.
METHODS: We conducted a retrospective cohort study using the National Inpatient Sample (NIS). From 157 434 LAAO hospitalizations identified, 133 517 were non-Hispanic white and 6814 were Hispanic/Latino. The primary outcome was in-hospital mortality.
RESULTS: Unadjusted odds in the Hispanic/Latino group were higher for mortality (OR 1.78, 95% CI 1.18-2.68, p 0.006), stroke (OR 1.64, 95% CI 1.26-2.14, p < 0.001), infectious complications (OR 3.89, 95% CI 3.03-4.99, p < 0.001), major bleeding (OR 1.22, 95% CI 1.11-1.33, p < 0.001), DVT/PE (OR 2.15, 95% CI 1.58-2.93, p < 0.001), and vascular complications (OR 1.81, 95% CI 0.53-0.93, p < 0.001). After adjusting for covariates and comorbidities, Hispanic/Latino patients had still greater odds of mortality (aOR 1.20, 95% CI 0.75-1.92, p 0.445), infectious complications (aOR 3.54, 95% CI 2.62-4.55, p < 0.001), and vascular complications (aOR 1.57, 95% CI 1.22-2.03, p < 0.001). Non-Hispanic white patients had higher adjusted odds of pericardial effusion/tamponade (aOR 0.64, 95% CI 0.52-0.95, p 0.03), while Hispanic/Latino patients also had higher adjusted odds of cardiac arrest (aOR 1.99, 95% CI 1.15-3.42, p 0.46).
CONCLUSION: Hispanic/Latino patients undergoing LAAO experience higher odds of infectious and vascular complications compared to non-Hispanic white patients. These findings highlight the need to further investigate disparities in procedural outcomes.