Racial and ethnic differences and temporal changes in outcomes following transcatheter aortic valve replacement in urban hospitals

Authors

• Rezwan Munshi, Department of Medicine, Division of Cardiology, University of Minnesota Medical School, Minneapolis, MN, USA.
• Sahil Ghay, Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA; Semyon and Janna Friedman Advanced Research Institute at Mount Sinai Medical Center, Miami Beach, FL, USA; Division of Cardiology, Mount Sinai Medical Center, Miami Beach, FL, USA.
• Ralph Daher, Cooper University Healthcare, Camden, NJ, USA.
• Koushik Sanku, Division of Cardiology, Mount Sinai Medical Center, Miami Beach, FL, USA.
• Christos G. Mihos, Division of Cardiology, Mount Sinai Medical Center, Miami Beach, FL, USA.
• Rachel Shatanof, Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA; Semyon and Janna Friedman Advanced Research Institute at Mount Sinai Medical Center, Miami Beach, FL, USA; Division of Cardiology, Mount Sinai Medical Center, Miami Beach, FL, USA.
• Mohamed H. Raafat, Regional Hospital of Scranton, Scranton, PA, USA.
• Ahmad Kassar, Division of Cardiology, Mount Sinai Medical Center, Miami Beach, FL, USA.
• Marissa Donatelle, Division of Cardiology, Mount Sinai Medical Center, Miami Beach, FL, USA.
• Francisco Ujueta, Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
• Priscilla Wessly, Advocate Health - MidwestFollow
• Francine K. Welty, Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
• Abdulhamied Alfaddagh, Jabar AlAhmad Hospital, South Surra, Kuwait.
• Tarec K. Elajami, Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA; Semyon and Janna Friedman Advanced Research Institute at Mount Sinai Medical Center, Miami Beach, FL, USA; Division of Cardiology, Mount Sinai Medical Center, Miami Beach, FL, USA; New York Medical College, School of Medicine, Valhalla, NY, USA. Electronic address: Tarec.Elajami@msmc.com.
• Amr E. Abbas, Corewell Health East, William Beaumont University Hospital, Royal Oak, MI, USA.
• Andres Palomo, Semyon and Janna Friedman Advanced Research Institute at Mount Sinai Medical Center, Miami Beach, FL, USA; Division of Cardiology, Mount Sinai Medical Center, Miami Beach, FL, USA. Electronic address: Andres.Palomo@msmc.com.

Recommended Citation

Munshi R, Ghay S, Daher R, et al. Racial and ethnic differences and temporal changes in outcomes following transcatheter aortic valve replacement in urban hospitals. Cardiovasc Revasc Med. Published online April 30, 2026. doi:10.1016/j.carrev.2026.04.018

Affiliations

Aurora Sinai/Aurora St. Luke’s Medical Centers

Abstract

Introduction: Transcatheter aortic valve replacement (TAVR) is an established treatment for severe aortic stenosis. Although TAVR has improved clinical outcomes, data on racial and ethnic differences in in-hospital clinical outcomes and their temporal trends, particularly within urban hospital settings, remain limited. Accordingly, we examined racial and ethnic differences in in-hospital outcomes and their temporal trends among patients undergoing TAVR in urban hospitals.

Methods: We utilized the National Inpatient Sample from 2016 through 2022 and identified TAVR-related hospitalizations in urban hospitals. Patients were classified by race and ethnicity, with White patients serving as the reference group. Primary endpoints included in-hospital mortality and major adverse cardiovascular events. Secondary endpoints included acute myocardial infarction, stroke, cardiac arrest, acute kidney injury, need for transfusion, mechanical ventilation, and other in-hospital complications. Survey-weighted multivariable analyses were performed.

Results: We identified a weighted total of 469,175 hospitalizations for TAVR in urban hospitals. Overall, 87.1% of patients were White, and 12.9% were racial and ethnic minority patients. Compared with White patients, Black and Hispanic patients had higher adjusted odds of major adverse cardiovascular events, driven in part by acute myocardial infarction, while Hispanic patients also had higher in-hospital mortality. Rates of ischemic and hemorrhagic stroke did not differ significantly across groups. Significant race-by-year interactions were observed for in-hospital mortality and blood transfusion.

Conclusions: Our findings highlight persistent racial and ethnic disparities in in-hospital outcomes following TAVR, emphasizing the need for targeted efforts to address inequities in care delivery.

Document Type

Article

PubMed ID

42097944