科学研究 - The Left Main and Coronary Artery Bifurcation Lesion Summit (CBS)

Why NOBLE and EXCEL Are Consistent With Each Other and With Previous Trials
Noninvasive Imaging for the Evaluation of Diastolic Function: Promises Fulfilled
Contribution of stent underexpansion to recurrence after sirolimus-eluting stent implantation for in-stent restenosis
Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main and Multivessel Coronary Artery Disease: Do We Have the Evidence?
Active SB-P Versus Conventional Approach to the Protection of High-Risk Side Branches: The CIT-RESOLVE Trial
Health Status After Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis
Positive remodeling at 3 year follow up is associated with plaque-free coronary wall segment at baseline: a serial IVUS study
Successful bailout stenting strategy against lethal coronary dissection involving left main bifurcation
Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance
Management of left main disease: an update

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Perspective

Volume 74, Issue 18, November 2019

JOURNAL：J Am Coll Cardiol.

Article Link

Aortic Valve Stenosis Treatment Disparities in the Underserved JACC Council Perspectives

W Batchelor, S Anwaruddin, L Ross et al.

11494

Keywords: aortic stenosis; health care disparities; outcomes; prevalence; TAVR

ABSTRACT

Underserved minorities make up a disproportionately small subset of patients in the United States undergoing transcatheter and surgical aortic valve replacement for aortic stenosis. The reasons for these treatment gaps include differences in disease prevalence and patient, health care system, and disease-related factors. This has major implications not only for minority patients, but also for other groups who face similar challenges in accessing state-of-the-art care for structural heart disease. The authors propose the following key strategies to address these treatment disparities: 1) implementation of measure-based quality improvement programs; 2) effective culturally competent communication and team-based care; 3) improving patient health care access, education, and effective diagnosis; and 4) changing the research paradigm that creates an innovation pipeline for patients. Only a concerted effort from all stakeholders will achieve equitable and broad application of this and other novel structural heart disease treatment modalities in the future.