Racial Disparities in the Utilization and Outcomes of TAVR

Transcatheter versus surgical aortic valve replacement in patients with end stage renal disease

“…These findings were consistent with prior data showing the underrepresentation of racial minorities in patients undergoing TAVR 28 . The transcatheter valve therapy (TVT) registry showed that in 70,221 patients undergoing TAVR, the majority (91%) were Caucasians, whereas African Americans, and Hispanics were 3.8 and 3.4%, respectively 28 . The most likely reasons for this disparity are the relatively lower prevalence of AS in racial minorities, 29 referral and detection bias for AVR favoring Whites over other racial groups, 30,31 and limited access to care due to cultural beliefs, or socioeconomic limitations among minorities 31 .…”

“…Overall, Caucasians were more prevalent, and African Americans and Hispanics were underrepresented in the TAVR group. These findings were consistent with prior data showing the underrepresentation of racial minorities in patients undergoing TAVR 28 . The transcatheter valve therapy (TVT) registry showed that in 70,221 patients undergoing TAVR, the majority (91%) were Caucasians, whereas African Americans, and Hispanics were 3.8 and 3.4%, respectively 28 .…”

“…The most likely reasons for this disparity are the relatively lower prevalence of AS in racial minorities, 29 referral and detection bias for AVR favoring Whites over other racial groups, 30,31 and limited access to care due to cultural beliefs, or socioeconomic limitations among minorities 31 . Regardless, in the TVT registry, the adjusted 30‐day and 1‐year outcomes in non‐Whites were comparable with those of Whites, 28 suggesting the benefits of TAVR over SAVR are unlikely to be influenced by racial differences.…”

Temporal Trends in Resource Use, Cost, and Outcomes of Transcatheter Aortic Valve Replacement in the United States

“…In addition, several studies on TAVR using TVT registry, the NRD, and other databases used ICD codes spanning pre-/ post-2015 without documented issues. 3,11,15,19 CONCLUSION This study documents a substantial improvement in the clinical outcomes of TAVR in the United States between 2012 and 2017. It also shows a temporal decrease in the burden of hospitalizations before and after TAVR, and a significant decrease in resource use and cost during the index TAVR admission.…”

Commentary: Do you live in a distressed community? How do you know? What does this mean? What are the risks? How do you get help?

“…Most, but not all, common medical and surgical disorders have worse outcomes in patients from distressed communities ( Table 1). [8][9][10][11][12][13][14][15][16][17][18][19][20][21] DOES LIVING IN A DISTRESSED COMMUNITY CAUSE WORSE OUTCOMES FROM SURGICAL PROCEDURES? Table 1 suggests that living in a distressed community is associated with worse outcomes from many medical disorders and from surgical interventions.…”