Racial Disparities in the Utilization and Outcomes of Structural Heart Disease Interventions in the United States
Open accessAbstract
Background: Data on race‐ and ethnicity‐based disparities in the utilization and outcomes of structural heart disease interventions in the United States are scarce. Methods and Results: We used the National Inpatient Sample (2011‐2016) to examine racial and ethnic differences in the utilization, in‐hospital outcomes, and cost of structural heart disease interventions among patients ≥65 years of age. A total of 106 119 weighted hospitalizations for transcatheter aortic valve replacement, transcatheter mitral valve repair, and left atrial appendage occlusion were included. The utilization rates (defined as the number of procedures performed per 100 000 US people >65 years of age) were higher in whites compared with blacks and Hispanics for transcatheter aortic valve replacement (43.1 versus 18.0 versus 21.1), transcatheter mitral valve repair (5.0 versus 3.2 versus 3.2), and left atrial appendage occlusion (6.6 versus 2.1 versus 3.5), respectively ( P <0.001). Black and Hispanic patients had distinctive socioeconomic and clinical risk profiles compared with white patients. There were no significant differences in the adjusted in‐hospital mortality or key complications between patients of white race, black race, and Hispanic ethnicity following transcatheter aortic valve replacement, transcatheter mitral valve repair, or left atrial appendage occlusion. No difference in cost was observed between white and black patients following any of the 3 procedures. However, Hispanic patients incurred modestly higher cost with transcatheter mitral valve repair and left atrial appendage occlusion compared with white patients. Conclusions: Racial and ethnic disparities exist in the utilization of structural heart disease interventions in the United States. Nonetheless, adjusted in‐hospital outcomes were comparable among white, black, and Hispanic patients. Further studies are needed to understand the reasons for these utilization disparities.
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Structural heart diseases are often diagnosed after the development of clinical symptoms, leading to poor health outcomes.
“Consequently, these conditions are often diagnosed after the development of clinical symptoms, leading to poor health outcomes.4-6”
From Ensemble Deep Learning Algorithm for Structural Heart Disease Screening Using Electrocardiographic Images (2025) · cites this paper as [4]
The Introduction and Discussion address racial disparities in access to structural heart disease interventions, while the Conclusions address short-term outcomes after those procedures. Our copy does not say that these conditions are often diagnosed after symptoms develop or that such diagnostic timing leads to poor outcomes (searched for diagnosis after symptoms and late diagnosis with poor outcomes). (LLM, conf=0.75)
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Research works printed but not linked: 17
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Cited by
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Dhingra, L. S., Aminorroaya, A., Sangha, V., Pedroso, A. F., Shankar, S. V., Coppi, A., Foppa, M., Brant, L. C. C., Barreto, S. M., Ribeiro, A. L. P., et al. (2025) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2025.01.030 · Cited by 53 · see citing works
- Authors
- Alkhouli, M., Alqahtani, F., Holmes, D. R., & Berzingi, C.
- Affiliations
- West Virginia University (US)
- Mayo Clinic (US)
- Corresponding author
- Alkhouli, Mohamad
- Venue
- Journal of the American Heart Association
- Published
- 2019-08-06
- Volume
- 8
- Issue
- 15
- Pages
- e012125-e012125
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC6761641
- OpenAlex
- W2962841337
- Cited by
- 81
- References
- 0
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 17 · 2023: 13 · 2022: 19 · 2021: 16 · 2020: 3 · 2019: 1 · 2017: 1
- FWCI
- 7.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of the American Heart Association (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- The Research Repository @ WVU (West Virginia University) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Disease and Treatment Approaches
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- racial disparities, ethnic disparities, structural heart disease, transcatheter aortic valve implantation, transcatheter mitral valve repair, left atrial appendage closure, in-hospital mortality, health care utilization, health care costs, older adults, Black patients, Hispanic patients, socioeconomic risk factors
- MeSH terms
- Facilities and Services Utilization, Aged, Aged, 80 and over, Black or African American, Female, Heart Diseases, Hispanic or Latino, Humans, Male, United States, Treatment Outcome, White People, Healthcare Disparities
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