Key result
Black individuals undergoing left atrial appendage occlusion were significantly younger, had a higher burden of comorbidities, and experienced higher rates of bleeding requiring transfusion (10.1% vs 6.7%) compared to White individuals.
Why the study?
Racial and ethnic inequities exist in AF management, and percutaneous LAAO may not be equally accessible to eligible patients.
Do Black and Hispanic individuals have greater comorbidity burdens and higher rates of in-hospital adverse outcomes compared to White individuals when undergoing left atrial appendage occlusion?
Cohort (n=20,065)
Yes
Do Black and Hispanic individuals have greater comorbidity burdens and higher rates of in-hospital adverse outcomes compared to White individuals when undergoing left atrial appendage occlusion?
Absolute Event Rate: 10.1% vs 6.7%
p-value: p=0.0002
There are significant racial and ethnic disparities in LAAO utilization and outcomes, with Black individuals presenting at younger ages with greater comorbidity burdens and experiencing higher rates of post-procedural bleeding requiring transfusion.
Racial and ethnic inequities have been reported in atrial fibrillation (AF) management. Percutaneous left atrial appendage occlusion (LAAO) provides mechanical stroke prophylaxis for AF patients who cannot tolerate long-term oral anticoagulants because of bleeding, but the technology may not be equally accessible to eligible patients. We hypothesize that compared to White individuals, Black and Hispanic individuals have greater comorbidity burden by the time they receive LAAO, and they may be more likely to experience in-hospital adverse outcomes.
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Helm et al. (2024) conducted a cohort in Atrial fibrillation or atrial flutter undergoing LAAO (n=20,065). Black, Hispanic, Asian, or Other race/ethnicity (focus on Black race) vs. White race was evaluated on In-hospital bleeding requiring transfusion (p=0.0002). Black individuals undergoing left atrial appendage occlusion were significantly younger, had a higher burden of comorbidities, and experienced higher rates of bleeding requiring transfusion (10.1% vs 6.7%) compared to White individuals.
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