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Comprehensive intravascular ultrasound assessment of stent area and its impact on restenosis and adverse cardiac events in 403 patients with unprotected left main disease Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure Timing of Intervention in Aortic Stenosis The Role of Vascular Imaging in Guiding Routine Percutaneous Coronary Interventions: A Meta-Analysis of Bare Metal Stent and Drug-Eluting Stent Trials Optical coherence tomography and intravascular ultrasound assessment of the anatomic size and wall thickness of a muscle bridge segment In patients with stable coronary heart disease, low-density lipoprotein-cholesterol levels < 70 mg/dL and glycosylated hemoglobin A1c < 7% are associated with lower major cardiovascular events In-stent neoatherosclerosis: a final common pathway of late stent failure Aliskiren, Enalapril, or Aliskiren and Enalapril in Heart Failure Coronary calcification in the diagnosis of coronary artery disease The Management of Atrial Fibrillation in Heart Failure: An Expert Panel Consensus

PerspectiveVolume 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. 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.