Cracking the Zip Code: Uncovering the Link Between Socioeconomic Status and Transcatheter Aortic Valve Replacement...

Area of Science:

• Cardiovascular Medicine
• Health Services Research
• Socioeconomic Determinants of Health

Background:

• Lower socioeconomic status is linked to poorer health outcomes.
• Zip codes and the CDC's Social Vulnerability Index (SVI) can represent socioeconomic status.
• These surrogates are useful for comparing outcomes after transcatheter aortic valve replacement (TAVR).

Purpose of the Study:

• To compare TAVR outcomes between patients of lower and higher socioeconomic status.
• To investigate the association between SVI and adverse events post-TAVR.

Main Methods:

• Retrospective study of 276 TAVR patients (March 2018 - June 2023).
• Patients categorized into lower income group (LIG) and higher income group (HIG) using Census Bureau data and SVI.
• Primary outcomes: major adverse cardiac events (MACE) and all-cause death at 30 days, 6 months, and 12 months.

Main Results:

• 80% of patients were in the LIG (222/276).
• No significant differences in primary or secondary outcomes between LIG and HIG at 6 or 12 months.
• Higher SVI was associated with increased bleeding events at 12 months.

Conclusions:

• TAVR outcomes are comparable between lower and higher income groups at 6 and 12 months.
• Patients in areas with higher SVI (greater vulnerability) had more periprocedural bleeding events.