Contemporary Trends of Racial and Social Disparities in Left Atrial Appendage Closure Procedure: Insights From the National Inpatient Sample

Author Type(s)

Resident/Fellow

Document Type

Abstract

Publication Date

2022

Journal Title

Journal of the American College of Cardiology

Department

Medicine

Abstract

Background: Racial and social disparities in the utilization of cardiovascular interventions, including left atrial appendage occlusion (LAAO), exist in clinical practice. Data on contemporary trends of such disparities are lacking. Methods: The National Inpatient Sample (NIS) for the years 2016 to 2019 was queried for adult admissions above age 65 years with a diagnosis of atrial fibrillation (AF). The primary endpoint was LAAO utilization per income (≤median vs >median) and race per 100,000 AF admissions and temporal trends of utilization over the years. Logistic regression was utilized to calculate temporal trends. Results: A total of 13.8 million admissions with AF were assessed, of which 53,310 underwent LAAO (mean age 77 ± 6 years; 42% female). LAAO utilization was different between races (405 vs 197 vs 340 per 100,000 AF admissions in White, Black, and Hispanic individuals, respectively; P < 0.001). Admissions with income ≤median had lower LAAO rates than the >median income group (344 vs 428 per 100,000 AF admissions; P < 0.001). From Q1 2016 to 2019, utilization of LAAO showed an upward trend in all races and income groups (Ptrend < 0.001). However, a significant disparity exists in the utilization of LAAO in the Black population compared with the White population and in the ≤median income group compared with the >median income group (Figures 1 and 2). [Formula presented] Conclusion: Our contemporary analysis demonstrated the persistence of racial and social disparities in the utilization of LAAO. Further studies are needed to determine the causes of such disparities and develop strategies to ensure access to these procedures for at-risk populations. Categories: STRUCTURAL: Left Atrial Appendage Exclusion

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