Racial Differences in the Prevalence of Severe Aortic Stenosis
| Autor: | Frank E. Harrell, Mark A. Robbins, Thomas J. Wang, Kelly D. Green, Devin K. Patel, Marat Fudim |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty aortic valve stenosis race and ethnicity Lower risk White People Young Adult Risk Factors Bicuspid valve Internal medicine Epidemiology Prevalence medicine Humans Young adult Risk factor database Aged Original Research Aged 80 and over Mitral regurgitation business.industry Age Factors Middle Aged medicine.disease Tennessee Surgery Black or African American Stenosis Logistic Models risk factor Echocardiography Valvular Heart Disease Aortic valve stenosis Cardiology Female epidemiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| DOI: | 10.1161/jaha.114.000879 |
| Popis: | Background In an era of expanded treatment options for severe aortic stenosis, it is important to understand risk factors for the condition. It has been suggested that severe aortic stenosis is less common in African Americans, but there are limited data from large studies. Methods and Results The Synthetic Derivative at Vanderbilt University Medical Center, a database of over 2.1 million de‐identified patient records, was used to identify individuals who had undergone echocardiography. The association of race with severe aortic stenosis was examined using multivariable logistic regression analyses adjusting for conventional risk factors. Of the 272 429 eligible patients (mean age 45 years, 44% male) with echocardiography, 14% were African American and 82% were Caucasian. Severe aortic stenosis was identified in 106 (0.29%) African‐American patients and 2030 (0.91%) Caucasian patients (crude OR 0.32, 95% CI [0.26, 0.38]). This difference persisted in multivariable‐adjusted analyses ( OR 0.41 [0.33, 0.50], P OR 0.47 [0.36, 0.61]) or congenitally bicuspid valve (crude OR 0.13 [0.02, 0.80], adjusted OR dependent on age). Referral bias against those with severe valvular disease was assessed by comparing the prevalence of severe mitral regurgitation in Caucasians and African Americans and no difference was found. Conclusions These findings suggest that African Americans are at significantly lower risk of developing severe aortic stenosis than Caucasians. |
| Databáze: | OpenAIRE |
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