Inter-racial differences in patients undergoing transcatheter aortic valve implantation. Issue 19 (2nd February 2022)

• Record Type: Journal Article
• Authors: Kang, Do-Yoon; Ahn, Jung-Min; Kim, Juyong Brian; Yeung, Alan; Nishi, Takeshi; Fearon, William; Cantey, Eric Page; Flaherty, James D; Davidson, Charles J; Malaisrie, S Christopher; Park, Seo Young; Yun, Sung-Cheol; Ko, Euihong; Park, Hanbit; Lee, Seung-Ah; Kim, Dae-Hee; Kim, Ho Jin; Kim, Joon Bum; Choo, Suk Jung; Park, Duk-Woo; Park, Seung-Jung
• Is Part Of: Heart. Volume 108:Issue 19(2022)
• Page Start: 1562
• Page End: 1570
• Publication Date: 2022-02-02
• Subjects: aortic valve stenosis -- transcatheter aortic valve replacement -- risk factors; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2021-320364
• Languages: English
• ISSNs: 1355-6037

Abstract

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 1 year. 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 1 year 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 ).