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Racial Disparities Among Patients Undergoing Balloon-Expandable Transcatheter Aortic Valve Replacement.

Karthik Vedantam1, Christian A Torres1, Sammy Elmariah2

  • 1Columbia University Division of Cardiology at the Mount Sinai Medical Center, Miami Beach, Florida.

Journal of the Society for Cardiovascular Angiography & Interventions
|March 20, 2025
PubMed
Summary
This summary is machine-generated.

Transcatheter aortic valve replacement (TAVR) shows improving utilization trends in Hispanic and Asian populations. Outcomes are favorable across ethnic groups, but Black patients still have low TAVR use despite comparable results.

Keywords:
outcomesrace/ethnicitytranscatheter aortic valve replacementtrends

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Area of Science:

  • Cardiovascular Medicine
  • Health Disparities Research
  • Interventional Cardiology

Background:

  • Aortic stenosis is a prevalent acquired native valve disease.
  • Transcatheter aortic valve replacement (TAVR) is a key treatment for severe aortic stenosis.
  • Existing research indicates racial and ethnic disparities in TAVR utilization and outcomes.

Purpose of the Study:

  • To analyze TAVR volume trends by race/ethnicity.
  • To assess the association between race/ethnicity and TAVR outcomes.
  • To identify and address disparities in TAVR utilization and results.

Main Methods:

  • Utilized the Transcatheter Valve Therapy Registry (November 2011-June 2023).
  • Evaluated SAPIEN balloon-expandable TAVR volume trends across racial/ethnic groups.
  • Analyzed in-hospital and 1-year major adverse cardiac events (MACE).

Main Results:

  • Identified 395,618 patients: 90.42% White, 4.75% Hispanic, 3.82% Black, 1.01% Asian.
  • Observed rising TAVR proportional usage in Hispanic (3.3% to 5.2%) and Asian (1.1% to 1.3%) patients (P < .01).
  • Found comparable 1-year MACE in Black patients (HR 1.00) and lower MACE in Asian (HR 0.91) and Hispanic (HR 0.89) patients versus White patients.

Conclusions:

  • Favorable TAVR outcomes exist across diverse ethnic groups, even with higher comorbidities.
  • Modest improvements in TAVR utilization disparities for Asian and Hispanic patients noted.
  • Low TAVR utilization persists in Black patients despite favorable outcomes, requiring further investigation and mitigation efforts.