Meta-Analysis on the Racial Disparity of Outcomes Following Alcohol Septal Ablation in Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a prevalent cardiac condition that often leads to heart failure, exertional syncope, and sudden cardiac death. Despite the availability of various treatments for HCM, such as septal reduction therapy through surgical septal myectomy or alcohol septal ablation (ASA), disparities in access to care and treatment outcomes persist, particularly among marginalized racial and ethnic groups. These disparities underscore the importance of understanding the influence of race, ethnicity, and regional factors on the management and outcomes of HCM, necessitating a closer examination of whether access to ASA and its associated benefits is equitably distributed across diverse populations. A comprehensive literature search was conducted on various electronic databases aimed to identify studies evaluating the odds of undergoing ASA in HCM in racial subgroups and outcomes like all-cause mortality and stroke. Three studies were included in this meta-analysis with a total sample size of 24,939 HCM patients. Adjusted odds ratio (OR) or pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random-effects model. Blacks were significantly less likely to undergo ASA for HCM (OR, 0.64; 95% CI, 0.57-0.72; P < 0.01) as compared to white patients; however, no differences in all-cause mortality (RR, 0.97; 95% CI, 0.54-1.75) and stroke (RR, 1.29; 95% CI, 0.76-2.18) were noted. In conclusion, this meta-analysis highlights a significant association between race and the likelihood of undergoing ASA among patients with HCM, with minority racial groups potentially facing barriers to accessing this advanced treatment.