TCT-747 Sex and Racial Disparities in Patients Undergoing Left Atrial Appendage Closure in The United States – A Nationwide Analysis between 2018 to 2021

Document Type

Conference Proceeding

Publication Date

10-22-2025

Publication Title

J Am Coll Cardiol

Keywords

hypertensive factor, acute heart failure, adult, age, aged, bleeding, Caucasian, cohort analysis, conference abstract, female, heart arrest, heart atrium appendage, heart failure, human, left atrial appendage closure, major clinical study, male, middle aged, mortality, pericardial effusion, racial disparity, sex, special situation for pharmacovigilance, therapy, United States

Abstract

Background: Limited data exist on sex and racial disparities in outcomes following left atrial appendage closure (LAAC). We aimed to examine these disparities in a nationwide cohort. Methods: We analyzed data from the National Inpatient Sample Database (2018-2021) for adult patients undergoing LAAC. Patients younger than 18 or missing demographic information were excluded. Multivariable logistic regression was used to assess independent associations. Results: A total of 120,935 patients were included (mean age 76±8 years; 42% female; 86% White, 7% Black). Females had significantly higher odds of mortality (OR 1.66; 95% CI 1.18-2.34; p=0.003), acute heart failure (OR 1.26; 95% CI 1.17-1.37; p<0.0001), AKI (OR 1.18; 95% CI 1.09-1.28; p<0.0001), bleeding (OR 1.07; 95% CI 1.02-1.13; p=0.009), pericardial effusion tamponade (OR 2.01; 95% CI 1.68-2.41; p<0.0001), vasopressor use (OR 1.17; 95% CI 1.01-1.36; p=0.04), and cardiac arrest (OR 1.61; 95% CI 1.08-2.37; p=0.01). Black patients exhibited higher odds of mortality (OR 2.77; 95% CI 1.58-4.86; p=0.0003), heart failure (OR 1.33; 95% CI 1.15-1.55; p=0.0001), AKI (OR 1.21; 95% CI 1.03-1.41; p=0.02), bleeding (OR 1.59; 95% CI 1.42-1.77; p<0.0001), vasopressor use (OR 2.54; 95% CI 1.97-3.27; p<0.0001), and cardiac arrest (OR 6.64; 95% CI 4.08-10.79; p<0.0001), but not pericardial effusion (OR 1.08; 95% CI 0.71-1.62; p=0.72). [Formula presented] Conclusion: Significant sex and racial disparities exist in LAAC outcomes, with females and Black patients experiencing worse outcomes. Further studies and interventions are needed to address these disparities. Categories: STRUCTURAL: Left Atrial Appendage Exclusion

Volume

86

Issue

17

First Page

B325

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