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Sex, Race, and Socioeconomic Disparities in Patients With Aortic Stenosis (from a Nationwide Inpatient Sample)
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Aortic stenosis (AS) is the third most prevalent cardiovascular disease following hypertension and coronary artery disease. The primary objective of this cross-sectional study is to examine gender, racial, and socioeconomic disparities in AS-related health care utilization in patients aged ≥50 years using data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample. AS was identified among inpatient discharges with International Classification of Diseases, Ninth Revision, Clinical Modification, code 424.1. Using stratum-specific weighted totals, means, proportions, and regression models, we examined time trends and disparities for inhospital AS prevalence according to gender, race, and income over the 2002 to 2012 period, predictors of AS (gender, race, income, age, health insurance, co-morbidities, and hospital-level characteristics), and AS's role as a predictor of inhospital death, length of stay, and total charges. Inhospital AS prevalence increased from 2.10% in 2002 to 2.37% in 2012, with similar trends observed within gender, race, and income strata. Women were less likely to have AS compared with men (adjusted odds ratio [ORadj] 0.84; 95% confidence interval [CI] 0.83 to 0.86). Blacks (ORadj 0.68; 95% CI 0.66 to 0.71), Hispanics (ORadj 0.79; 95% CI 0.76 to 0.84), and Asians/Pacific Islanders (ORadj 0.68; 95% CI 0.64 to 0.74) were less likely than whites to have AS diagnosis that was directly associated with income. AS was inversely related to inhospital death but positively linked to total charges overall and longer hospital stays among men, whites, and middle-income patients. However, shorter stays with AS were observed among blacks. In conclusion, among older inpatients, AS prevalence was ∼2% and was higher among males, whites, and higher income groups. Although inhospital death was lower and total charges were higher in AS, length of stay's association with AS varied by gender, race, and income.
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Severe AS is less prevalent among NH-Black individuals, and the frequency of bicuspid morphology is lower.
“Among the few studies published to date reporting on the race/ethnicity implications it has been shown that severe AS is less prevalent among NH-Black, as well as the frequency of bicuspid morphology23,24.”
From Characterization of Aortic Valve Stenosis by CT Angiography in a Diverse US Cohort (2025) · cites this paper as [24]
The Results and Discussion (page not available) report that Black inpatients were less likely than white inpatients to have an AS diagnosis. The study does not establish that *severe* AS is less prevalent, and it provides no finding on the frequency of bicuspid morphology; bicuspid valves appear only in a reference title. (LLM, conf=0.86)
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Research works printed but not linked: 19
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Cited by
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Fleury, M.-A., & Clavel, M.-A. (2021) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2021.02.003 · Cited by 58
Characterization of Aortic Valve Stenosis by CT Angiography in a Diverse US Cohort
Lorenzatti, D., Filtz, A., Pina, P., Geers, J., Gilman, J., Daich, J., Ippolito, P., Aftab, A., Schenone, A. L., Gongora, C. A., et al. (2025) · Circulation: Cardiovascular Imaging · doi:10.1161/circimaging.124.017858 · Cited by 7
Metadata
- Authors
- Beydoun, H. A., Beydoun, M. A., Liang, H., Dore, G. A., Shaked, D., Zonderman, A. B., & Eid, S. M.
- Affiliations
- Johns Hopkins University (US)
- National Institute on Aging (US)
- University of Maryland, Baltimore County (US)
- Corresponding author
- Beydoun, Hind A.
- ORCID
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2016-09
- Volume
- 118
- Issue
- 6
- Pages
- 860-865
- ISSN
- 0002-9149 (ISSN-L)
- PMC
- PMC5822040
- OpenAlex
- W2465291338
- Cited by
- 66
- References
- 0
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 8 · 2023: 13 · 2022: 11 · 2021: 12 · 2020: 5 · 2019: 2 · 2018: 1 · 2017: 3
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99 AG999999)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
- Keywords
- aortic stenosis, health care disparities, sex disparities, racial disparities, socioeconomic disparities, in-hospital mortality, length of hospital stay, hospital charges, older adults, gender differences, racial minorities
- MeSH terms
- Aged, Aortic Valve Stenosis, Asian, Black or African American, Ethnicity, Female, Hispanic or Latino, Humans, Income, Insurance, Health, Length of Stay, Male, Middle Aged, Sex Factors, Social Class, United States, Prevalence, Odds Ratio, Databases, Factual, Hospital Mortality, Hospital Charges, White People, Native Hawaiian or Pacific Islander, Native Hawaiian or Other Pacific Islander, Health Status Disparities
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