Author + information
- Ron Waksman,
- Kyle Buchanan,
- M. Chadi Alraies,
- Toby Rogers,
- Arie Steinvil,
- Edward Koifman,
- Joelle Salmon,
- Jiaxiang Gai,
- Rebecca Torguson,
- Petros Okubagzi,
- Itsik Ben-Dor,
- Augusto Pichard and
- Lowell Satler
Background: The broadening indications following the U.S. Food and Drug Administration approval of transcatheter aortic valve replacement (TAVR) have increased the treatment options for patients with severe aortic stenosis. It remains uncertain how these changes have influenced the demographics and characteristics of TAVR referrals.
Methods: We retrospectively analyzed all patients referred to our center for TAVR from 2010 to 2016. The patients were stratified into tertiles based on referral year (T1: 2010-2011, T2: 2012-2013, T3: 2014-2016). The baseline demographics and characteristics were compared between each cohort.
Results: 1,814 patients (83.0% caucasion, 13.0% black) were referred for TAVR. There was no difference in racial composition between the tertiles. Over a similar time period, 36.0% of patients referred for percutaneous coronary intervention were black (p<0.0001). Compared to the T1 cohort, T3 had a lower mean STS score (6.9±4.0 vs 9.8±5.8, p<0.001), less severe heart failure symptoms (72.8% vs 84.0%, p<0.001) and coronary artery disease (65.7% vs 75.8%, p=0.03) but more severe chronic obstructive pulmonary disease (17.4% vs 7.9%, p<0.001).
Conclusions: Referrals for TAVR have increased while baseline characteristics reflect a lower risk population, paralleling the expanded commercialization and trials involving intermediate risk patients. Despite broadening indications and more informed medical community, the disparity in race of TAVR referrals has not changed.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 2
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1195-173
- 2017 American College of Cardiology Foundation