Disparity among Asian Americans in transcatheter and surgical aortic valve replacement

Authors

Renxi Li, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States of America; Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, United States of America. Electronic address: renxili@gwu.edu.
Qianyun Luo, Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, United States of America.
Marat Yanavitski, M Health University of Minnesota Physicians, Cardiology East Division, Minneapolis, MN, United States of America.
Stephen J. Huddleston, Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, United States of America.

Document Type

Journal Article

Publication Date

9-1-2023

Journal

Cardiovascular revascularization medicine : including molecular interventions

DOI

10.1016/j.carrev.2023.08.016

Keywords

Asian Americans; Surgical aortic valve replacement; Transcatheter aortic valve replacement

Abstract

BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.

APA Citation

Li, Renxi; Luo, Qianyun; Yanavitski, Marat; and Huddleston, Stephen J., "Disparity among Asian Americans in transcatheter and surgical aortic valve replacement" (2023). GW Authored Works. Paper 3468.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3468

Department

School of Medicine and Health Sciences Student Works