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

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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