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Meta-analysis of outcomes after intravascular ultrasound-guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies Nocturnal thoracic volume overload and post-discharge outcomes in patients hospitalized for acute heart failure From Focal Lipid Storage to Systemic Inflammation Sex- and Race-Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction Association of Cardiovascular Disease With Respiratory Disease Association of Statin Use With All-Cause and Cardiovascular Mortality in US Veterans 75 Years and Older The Prevalence of Myocardial Bridging Associated with Coronary Endothelial Dysfunction in Patients with Chest Pain and Non-Obstructive Coronary Artery Disease Mediterranean Diet and the Association Between Air Pollution and Cardiovascular Disease Mortality Risk Extreme Levels of Air Pollution Associated With Changes in Biomarkers of Atherosclerotic Plaque Vulnerability and Thrombogenicity in Healthy Adults From Subclinical Atherosclerosis to Plaque Progression and Acute Coronary Events
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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.
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