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Racial and Ethnic Differences in Treatment and Outcomes of Severe Aortic Stenosis: A Review.
JACC: Cardiovascular Interventions ( IF 11.7 ) Pub Date : 2020-01-27 , DOI: 10.1016/j.jcin.2019.08.056
Jimica B Wilson 1 , Larry R Jackson 2 , Francis E Ugowe 3 , Terrell Jones 4 , George S A Yankey 3 , Colin Marts 4 , Kevin L Thomas 2
Affiliation  

Aortic stenosis (AS) is among the most common valvular heart diseases encountered in the United States. In this review the authors examine differences between racial and ethnic groups in the epidemiology and management of severe AS, explore potential explanations for these findings, and discuss the implications for improving the delivery of care to racially and ethnically diverse populations. Underrepresented racial and ethnic groups experience a paradoxically lower prevalence or incidence of AS relative to white subjects, despite having a higher prevalence of traditional risk factors. Historically, UREGs with severe AS have had lower rates of both surgical and transcatheter aortic valve replacement and experienced more post-surgical complications, including, bleeding, worsening heart failure, and rehospitalization. Last, UREGs with severe AS have an increased risk for morbidity and mortality relative to white patients. To date much of the research on AS has examined black-white differences, so there is a need to understand how other racial and ethnic groups with severe AS are diagnosed and treated, with examination of their resulting outcomes. Overall, racial and ethnic disparities in health care access and care delivery are a public health concern given the changing demographics of the U.S. population. These differences in AS management and outcomes highlight the need for additional research into contributing factors and appropriate interventions to address the lower rates of aortic valve replacement and higher morbidity and mortality among UREGs.

中文翻译:

严重主动脉瓣狭窄的治疗和结果中的种族和种族差异:综述。

主动脉瓣狭窄(AS)是美国最常见的瓣膜性心脏病之一。在这篇综述中,作者研究了种族和族裔群体在严重AS的流行病学和管理方面的差异,探讨了这些发现的潜在解释,并讨论了对改善向种族和族裔不同群体提供医疗服务的意义。尽管白人的传统危险因素患病率较高,但代表性不足的种族和族裔的AS患病率或发病率却相对于白人受试者低。从历史上看,患有严重AS的UREG的手术和经导管主动脉瓣置换率均较低,并且术后发生的并发症更多,包括出血,心力衰竭加重和重新住院。持续,与白人患者相比,患有严重AS的UREG患病和死亡的风险增加。迄今为止,许多关于AS的研究都研究了黑白差异,因此有必要了解如何诊断和治疗其他患有严重AS的种族和族裔,并检查其结果。总体而言,鉴于美国人口结构的变化,在医疗保健获取和医疗提供方面的种族和族裔差异是公共卫生问题。AS管理和结果的这些差异突出表明,有必要进一步研究影响因素和适当的干预措施,以解决UREG患者主动脉瓣置换率较低以及发病率和死亡率较高的问题。迄今为止,许多关于AS的研究都研究了黑白差异,因此有必要了解如何诊断和治疗其他患有严重AS的种族和族裔,并检查其结果。总体而言,鉴于美国人口结构的变化,在医疗保健获取和医疗提供方面的种族和族裔差异是公共卫生问题。AS管理和结果的这些差异突出表明,有必要进一步研究影响因素和适当的干预措施,以解决UREG患者主动脉瓣置换率较低以及发病率和死亡率较高的问题。迄今为止,许多关于AS的研究都研究了黑白差异,因此有必要了解如何诊断和治疗其他患有严重AS的种族和族裔,并检查其结果。总体而言,鉴于美国人口结构的变化,在医疗保健获取和医疗提供方面的种族和族裔差异是公共卫生问题。AS管理和结果的这些差异突出表明,有必要进一步研究影响因素和适当的干预措施,以解决UREG患者主动脉瓣置换率较低以及发病率和死亡率较高的问题。鉴于美国人口结构的变化,在医疗保健和医疗提供方面的种族和族裔差异是公共卫生问题。AS管理和结果的这些差异突出表明,有必要进一步研究影响因素和适当的干预措施,以解决UREG患者主动脉瓣置换率较低以及发病率和死亡率较高的问题。鉴于美国人口的变化,在医疗保健和医疗提供方面的种族和族裔差异是公共卫生问题。AS管理和结果的这些差异突出表明,有必要进一步研究影响因素和适当的干预措施,以解决UREG患者主动脉瓣置换率较低以及发病率和死亡率较高的问题。
更新日期:2020-01-21
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