Inter-racial differences in patients undergoing transcatheter aortic valve implantation

Do Yoon Kang, Jung Min Ahn, Juyong Brian Kim, Alan Yeung, Takeshi Nishi, William Fearon, Eric Page Cantey, James D. Flaherty, Charles J. Davidson, S. Christopher Malaisrie, Seo Young Park, Sung Cheol Yun, Euihong Ko, Hanbit Park, Seung Ah Lee, Dae Hee Kim, Ho Jin Kim, Joon Bum Kim, Suk Jung Choo, Duk Woo Park*Seung Jung Park

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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).

Original languageEnglish (US)
Article numberheartjnl-2021-320364
JournalHeart
DOIs
StatePublished - Sep 12 2022

Keywords

  • aortic valve stenosis
  • risk factors
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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