Racial and Ethnic Disparities in Inpatient Outcomes of Tricuspid Transcatheter Edge-to-Edge Repair in the United States

美国三尖瓣经导管缘对缘修复术住院患者预后中的种族和民族差异

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Abstract

BACKGROUND: Tricuspid transcatheter edge-to-edge repair (T-TEER) has emerged as an effective and safe option for repair of tricuspid regurgitation in select patients. Prior studies on percutaneous cardiac interventions have demonstrated racial and ethnic disparities in procedural outcomes, but specific studies investigating T-TEER outcomes on a national level are limited. METHODS: National Inpatient Sample and International Classification of Diseases, Tenth Revision codes were used to identify patients who underwent T-TEER in the United States from 2018 to 2022. The study group was stratified based on race and ethnicity. Study outcomes included inpatient complications, outcomes, and resource utilization. RESULTS: A total of 2815 patients underwent T-TEER, with the racial and ethnic composition as follows: White (75.8%), Black (8.5%), Hispanic (6.2%), and Other (9.4%). Black patients had the highest incidence of major (14.6% vs 7.7% and 8.6%), overall (37.5% vs 21.5% and 28.6%), and cardiovascular (18.7% vs 7.5% and 11.4%) complications compared with White and Hispanic patients, respectively. After multivariable adjustment, Black patients had higher odds for major (adjusted OR [aOR], 1.93; 95% CI, 1.27-2.95) and overall (aOR, 2.51; 95% CI, 1.84-3.43) complications. Black and Hispanic patients had higher odds of prolonged length of stay (aOR, 2.47; 95% CI, 1.83-3.34) and (aOR, 3.40; 95% CI, 2.36-4.90), respectively. CONCLUSIONS: Racial and ethnic disparities in T-TEER outcomes are evident, with Black patients experiencing higher major and overall complications, and Black and Hispanic patients having prolonged hospitalizations. Further investigation into the specific factors and policies driving these disparities is crucial in striving for more equitable cardiovascular care among different racial and ethnic populations.

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