PMID- 29506780
OWN - NLM
STAT- MEDLINE
DCOM- 20190312
LR  - 20211204
IS  - 1942-5546 (Electronic)
IS  - 0025-6196 (Linking)
VI  - 93
IP  - 5
DP  - 2018 May
TI  - Effect of Race on the Incidence of Aortic Stenosis and Outcomes of Aortic Valve 
      Replacement in the United States.
PG  - 607-617
LID - S0025-6196(17)30880-7 [pii]
LID - 10.1016/j.mayocp.2017.11.026 [doi]
AB  - OBJECTIVE: To assess the effect of race on the incidence of aortic stenosis (AS) 
      and utilization and outcomes of aortic valve replacement (AVR). PATIENTS AND 
      METHODS: Patients older than 60 years hospitalized with a primary diagnosis of AS 
      and those who underwent AVR between 2003 and 2014 were included. Adjusted and 
      unadjusted incidence of AS-related hospitalizations, utilization rates of AVR, 
      in-hospital morbidity and mortality, and resource utilization was compared 
      between whites and African Americans (AAs). RESULTS: Between January 1, 2003, and 
      December 31, 2014, the incidence of AS-related admissions increased from 13 (95% 
      CI, 12.8-13.2) to 26 (95% CI, 25.7-26.4) cases per 100,000 patient-years in 
      whites and from 3 (95% CI, 3.5-3.8) to 9.5 (95% CI, 9.4-9.8) cases per 100,000 
      patient-years in AAs (P<.001). The incidence density ratio decreased from 4.3 
      (95% CI, 2.27-6.6) in 2003 to 2.7 (95% CI, 1.1-3.8) in 2014. The ratio of AVR to 
      AS-related admissions was 11.3% in whites and 6.7% in AAs (P<.001). Crude 
      in-hospital mortality after AVR was higher in AAs (6.4% vs 4.7%; P<.001). 
      However, after propensity score matching, in-hospital morality after isolated AVR 
      was not significantly different between AAs and whites (4.7% vs 3.7%; P=.12). 
      African Americans also had longer hospitalizations (12+/-12 days vs 10+/-9 days; 
      P<.001), higher rates of nonhome discharge (32.1% vs 27.2%; P=.004), and higher 
      cost of hospitalization ($55,631+/-$37,773 vs $52,521+/-$38,040; P<.001). 
      CONCLUSIONS: African Americans undergo AVR less than whites. The underlying 
      etiology of this disparity is multifactorial, but may be related to a lower 
      incidence of AS in AAs. Aortic valve replacement is associated with similar 
      risk-adjusted in-hospital mortality but higher cost and longer hospitalizations 
      in AAs than in whites.
CI  - Copyright (c) 2017 Mayo Foundation for Medical Education and Research. Published by 
      Elsevier Inc. All rights reserved.
FAU - Alqahtani, Fahad
AU  - Alqahtani F
AD  - Division of Cardiology, West Virginia University, Morgantown, WV.
FAU - Aljohani, Sami
AU  - Aljohani S
AD  - Division of Cardiology, West Virginia University, Morgantown, WV.
FAU - Amin, Ali Hama
AU  - Amin AH
AD  - Division of Cardiology, West Virginia University, Morgantown, WV.
FAU - Al-Hijji, Mohammed
AU  - Al-Hijji M
AD  - Department of Cardiology, Mayo Clinic, Rochester, MN.
FAU - Ali, Oluseun O
AU  - Ali OO
AD  - Novant Health Heart & Vascular Institute, Charlotte, NC.
FAU - Holmes, David R
AU  - Holmes DR
AD  - Department of Cardiology, Mayo Clinic, Rochester, MN.
FAU - Alkhouli, Mohamad
AU  - Alkhouli M
AD  - Division of Cardiology, West Virginia University, Morgantown, WV; Department of 
      Cardiology, Mayo Clinic, Rochester, MN. Electronic address: 
      Mohamad.Alkhouli@wvumedicine.org.
LA  - eng
PT  - Journal Article
DEP - 20180302
PL  - England
TA  - Mayo Clin Proc
JT  - Mayo Clinic proceedings
JID - 0405543
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Stenosis/epidemiology/*ethnology/*surgery
MH  - Ethnicity/*statistics & numerical data
MH  - Female
MH  - Heart Valve Prosthesis Implantation/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Discharge/*statistics & numerical data
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - United States
EDAT- 2018/03/07 06:00
MHDA- 2019/03/13 06:00
CRDT- 2018/03/07 06:00
PHST- 2017/09/06 00:00 [received]
PHST- 2017/10/28 00:00 [revised]
PHST- 2017/11/09 00:00 [accepted]
PHST- 2018/03/07 06:00 [pubmed]
PHST- 2019/03/13 06:00 [medline]
PHST- 2018/03/07 06:00 [entrez]
AID - S0025-6196(17)30880-7 [pii]
AID - 10.1016/j.mayocp.2017.11.026 [doi]
PST - ppublish
SO  - Mayo Clin Proc. 2018 May;93(5):607-617. doi: 10.1016/j.mayocp.2017.11.026. Epub 
      2018 Mar 2.