Disparity among Asian Americans in transcatheter and surgical aortic valve replacement

Racial disparities in transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) outcomes have been established, but research has predominantly focused on African Americans and Hispanics, leaving a gap in Asian Americans. This study aimed to investigate disparities in...

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Published in:Cardiovascular revascularization medicine 2024-02, Vol.59, p.84-90
Main Authors: Li, Renxi, Luo, Qianyun, Yanavitski, Marat, Huddleston, Stephen J.
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Language:English
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Asian Americans
Surgical aortic valve replacement
Transcatheter aortic valve replacement
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container_title Cardiovascular revascularization medicine
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creator Li, Renxi
Luo, Qianyun
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description Racial disparities in transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) outcomes have been established, but research has predominantly focused on African Americans and Hispanics, leaving a gap in Asian Americans. This study aimed to investigate disparities in aortic valve replacement outcomes among Asian Americans. Patients who underwent SAVR and TAVR were identified in National Inpatient Sample from the last quarter of 2015–2020. A 1:2 propensity score matching was applied to Asian Americans and Caucasians. In-hospital perioperative outcomes, length of stay, days from admission to operation, and total hospital charge, were compared. In TAVR, 51,394 (84.41 %) were Caucasians and 795 (1.31 %) were Asian Americans. In SAVR, there were 50,080 (78.52 %) Caucasians and 1233 (1.93 %) Asian Americans. No significant difference was found in post-TAVR complications. However, Asian Americans experienced longer waiting time until operation (p = 0.03) and higher costs (p 
doi_str_mv 10.1016/j.carrev.2023.08.016
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This study aimed to investigate disparities in aortic valve replacement outcomes among Asian Americans. Patients who underwent SAVR and TAVR were identified in National Inpatient Sample from the last quarter of 2015–2020. A 1:2 propensity score matching was applied to Asian Americans and Caucasians. In-hospital perioperative outcomes, length of stay, days from admission to operation, and total hospital charge, were compared. In TAVR, 51,394 (84.41 %) were Caucasians and 795 (1.31 %) were Asian Americans. In SAVR, there were 50,080 (78.52 %) Caucasians and 1233 (1.93 %) Asian Americans. No significant difference was found in post-TAVR complications. However, Asian Americans experienced longer waiting time until operation (p = 0.03) and higher costs (p < 0.01) in TAVR. In SAVR, Asian Americans had higher risks of in-hospital mortality (3.91 % vs 2.39 %, p = 0.01), cardiogenic shock (8.71 % vs 6.74 %, p = 0.03), respiratory complications (14.08 % vs 11.2 %, p = 0.01), mechanical ventilation (13.83 % vs 9.09 %, p < 0.01), acute kidney injury (25.47 % vs 20.13 %, p < 0.01), and hemorrhage/hematoma (72.01 % vs 62.95 %, p < 0.01). Additionally, Asian Americans underwent SAVR had longer lengths of stay (p < 0.01) and higher costs (p < 0.01). Asian Americans were underrepresented in aortic valve replacement. Asian Americans, while having similar post-TAVR outcomes to Caucasians, faced greater risks of post-SAVR mortality and surgical complications. These disparities among Asian Americans call for targeted actions to ensure equitable health outcomes. [Display omitted] •Racial disparities in TAVR and SAVR have been established, but there is a scarcity of literature examining Asian Americans.•This study is the first to comprehensively examined racial disparities in TAVR and SAVR among Asian Americans.•Asian Americans had similar post-TAVR outcomes to Caucasians but faced higher risks of post-SAVR mortality and complications.]]></description><identifier>ISSN: 1553-8389</identifier><identifier>EISSN: 1878-0938</identifier><identifier>DOI: 10.1016/j.carrev.2023.08.016</identifier><identifier>PMID: 37673721</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Asian Americans ; Surgical aortic valve replacement ; Transcatheter aortic valve replacement</subject><ispartof>Cardiovascular revascularization medicine, 2024-02, Vol.59, p.84-90</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. 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This study aimed to investigate disparities in aortic valve replacement outcomes among Asian Americans. Patients who underwent SAVR and TAVR were identified in National Inpatient Sample from the last quarter of 2015–2020. A 1:2 propensity score matching was applied to Asian Americans and Caucasians. In-hospital perioperative outcomes, length of stay, days from admission to operation, and total hospital charge, were compared. In TAVR, 51,394 (84.41 %) were Caucasians and 795 (1.31 %) were Asian Americans. In SAVR, there were 50,080 (78.52 %) Caucasians and 1233 (1.93 %) Asian Americans. No significant difference was found in post-TAVR complications. However, Asian Americans experienced longer waiting time until operation (p = 0.03) and higher costs (p < 0.01) in TAVR. In SAVR, Asian Americans had higher risks of in-hospital mortality (3.91 % vs 2.39 %, p = 0.01), cardiogenic shock (8.71 % vs 6.74 %, p = 0.03), respiratory complications (14.08 % vs 11.2 %, p = 0.01), mechanical ventilation (13.83 % vs 9.09 %, p < 0.01), acute kidney injury (25.47 % vs 20.13 %, p < 0.01), and hemorrhage/hematoma (72.01 % vs 62.95 %, p < 0.01). Additionally, Asian Americans underwent SAVR had longer lengths of stay (p < 0.01) and higher costs (p < 0.01). Asian Americans were underrepresented in aortic valve replacement. Asian Americans, while having similar post-TAVR outcomes to Caucasians, faced greater risks of post-SAVR mortality and surgical complications. These disparities among Asian Americans call for targeted actions to ensure equitable health outcomes. [Display omitted] •Racial disparities in TAVR and SAVR have been established, but there is a scarcity of literature examining Asian Americans.•This study is the first to comprehensively examined racial disparities in TAVR and SAVR among Asian Americans.•Asian Americans had similar post-TAVR outcomes to Caucasians but faced higher risks of post-SAVR mortality and complications.]]></description><subject>Asian Americans</subject><subject>Surgical aortic valve replacement</subject><subject>Transcatheter aortic valve replacement</subject><issn>1553-8389</issn><issn>1878-0938</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9UEtLAzEQDqL4_gciOXrZNY9ukr0IxTcIXtRrmGZna8o-apIW-u9NqXr0NB8z34P5CLngrOSMq-tF6SAEXJeCCVkyU-blHjnmRpuC1dLsZ1xVsjDS1EfkJMYFY1ILpQ_JkdRKZ8yPycedj0sIPm0o9OMwp9PoYaDTHoN3METqB5pCBg7SJyYMFIaGxlWY53NHYQzJO7qGbo004LIDhz0O6YwctNBFPP-Zp-T94f7t9ql4eX18vp2-FE4qkYoKQBldSakr42qm2gqhVVqYhte15Bwb1s5Ea7iQrZKiFk1Vo5aTCqVomQB5Sq52vsswfq0wJtv76LDrYMBxFa0wSmytzCRTJzuqC2OMAVu7DL6HsLGc2W2jdmF3jdpto5YZm5dZdvmTsJr12PyJfivMhJsdAfOfa4_BRudxcNj4gC7ZZvT_J3wD7TOJNA</recordid><startdate>202402</startdate><enddate>202402</enddate><creator>Li, Renxi</creator><creator>Luo, Qianyun</creator><creator>Yanavitski, Marat</creator><creator>Huddleston, Stephen J.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1691-6278</orcidid></search><sort><creationdate>202402</creationdate><title>Disparity among Asian Americans in transcatheter and surgical aortic valve replacement</title><author>Li, Renxi ; Luo, Qianyun ; Yanavitski, Marat ; Huddleston, Stephen J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-5aa687533758c906f5eaf6728d199311ed0fb2f8123f63292d59e7345e32f02a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Asian Americans</topic><topic>Surgical aortic valve replacement</topic><topic>Transcatheter aortic valve replacement</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Renxi</creatorcontrib><creatorcontrib>Luo, Qianyun</creatorcontrib><creatorcontrib>Yanavitski, Marat</creatorcontrib><creatorcontrib>Huddleston, Stephen J.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cardiovascular revascularization medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Renxi</au><au>Luo, Qianyun</au><au>Yanavitski, Marat</au><au>Huddleston, Stephen J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Disparity among Asian Americans in transcatheter and surgical aortic valve replacement</atitle><jtitle>Cardiovascular revascularization medicine</jtitle><addtitle>Cardiovasc Revasc Med</addtitle><date>2024-02</date><risdate>2024</risdate><volume>59</volume><spage>84</spage><epage>90</epage><pages>84-90</pages><issn>1553-8389</issn><eissn>1878-0938</eissn><abstract><![CDATA[Racial disparities in transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) outcomes have been established, but research has predominantly focused on African Americans and Hispanics, leaving a gap in Asian Americans. This study aimed to investigate disparities in aortic valve replacement outcomes among Asian Americans. Patients who underwent SAVR and TAVR were identified in National Inpatient Sample from the last quarter of 2015–2020. A 1:2 propensity score matching was applied to Asian Americans and Caucasians. In-hospital perioperative outcomes, length of stay, days from admission to operation, and total hospital charge, were compared. In TAVR, 51,394 (84.41 %) were Caucasians and 795 (1.31 %) were Asian Americans. In SAVR, there were 50,080 (78.52 %) Caucasians and 1233 (1.93 %) Asian Americans. No significant difference was found in post-TAVR complications. However, Asian Americans experienced longer waiting time until operation (p = 0.03) and higher costs (p < 0.01) in TAVR. In SAVR, Asian Americans had higher risks of in-hospital mortality (3.91 % vs 2.39 %, p = 0.01), cardiogenic shock (8.71 % vs 6.74 %, p = 0.03), respiratory complications (14.08 % vs 11.2 %, p = 0.01), mechanical ventilation (13.83 % vs 9.09 %, p < 0.01), acute kidney injury (25.47 % vs 20.13 %, p < 0.01), and hemorrhage/hematoma (72.01 % vs 62.95 %, p < 0.01). Additionally, Asian Americans underwent SAVR had longer lengths of stay (p < 0.01) and higher costs (p < 0.01). Asian Americans were underrepresented in aortic valve replacement. Asian Americans, while having similar post-TAVR outcomes to Caucasians, faced greater risks of post-SAVR mortality and surgical complications. These disparities among Asian Americans call for targeted actions to ensure equitable health outcomes. [Display omitted] •Racial disparities in TAVR and SAVR have been established, but there is a scarcity of literature examining Asian Americans.•This study is the first to comprehensively examined racial disparities in TAVR and SAVR among Asian Americans.•Asian Americans had similar post-TAVR outcomes to Caucasians but faced higher risks of post-SAVR mortality and complications.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37673721</pmid><doi>10.1016/j.carrev.2023.08.016</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-1691-6278</orcidid></addata></record>
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subjects Asian Americans
Surgical aortic valve replacement
Transcatheter aortic valve replacement
title Disparity among Asian Americans in transcatheter and surgical aortic valve replacement
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