Inter-racial differences in patients undergoing transcatheter aortic valve implantation. Heart (British Cardiac Society) Kang, D., Ahn, J., Kim, J. B., Yeung, A., Nishi, T., Fearon, W., Cantey, E. P., Flaherty, J. D., Davidson, C. J., Malaisrie, S. C., Park, S. Y., Yun, S., Ko, E., Park, H., Lee, S., Kim, D., Kim, H. J., Kim, J. B., Choo, S. J., Park, D., Park, S. 1800

Abstract

OBJECTIVE: Little information exists about inter-racial differences in patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). We investigated whether differences in baseline characteristics between Asian and non-Asian population may contribute to disparities in clinical outcomes after TAVI.METHODS: We performed a registry-based, multinational cohort study of patients with severe AS who underwent TAVI at two centres in the USA and one centre in South Korea. The primary outcome was a composite of death, stroke or rehospitalisation at 1year.RESULTS: Of 1412 patients, 581 patients were Asian and 831 were non-Asian (87.5% white, 1.7% black, 6.1% Hispanic or 4.7% others). There were substantial differences in baseline characteristics between two racial groups. The primary composite outcome was significantly lower in the Asian group than in the non-Asian group (26.0% vs 35.0%; HR 0.73; 95% CI 0.59 to 0.89; p=0.003). However, after adjustment of baseline covariates, the risk of primary composite outcome was not significantly different (HR 0.79; 95%CI 0.60 to 1.03; p=0.08). The all-cause mortality at 1year was significantly lower in the Asian group than the non-Asian group (7.4% vs 12.5%; HR 0.60; 95%CI 0.41 to 0.88; p=0.009). After multivariable adjustment, the risk of all-cause mortality was also similar (HR 1.17; 95%CI 0.73 to 1.88; p=0.52).CONCLUSIONS: There were significant differences in baseline and procedural factors among Asian and non-Asian patients who underwent TAVI. Observed inter-racial differences in clinical outcomes were largely explained by baseline differences in clinical, anatomical and procedural factors.TRIAL REGISTRATION NUMBER: NCT03826264 (https://wwwclinicaltrialsgov).

View details for DOI 10.1136/heartjnl-2021-320364

View details for PubMedID 35110384