TY - JOUR T1 - Racial, ethnic and socioeconomic disparities in patients undergoing left atrial appendage closure JF - Heart JO - Heart SP - 1946 LP - 1955 DO - 10.1136/heartjnl-2020-318650 VL - 107 IS - 24 AU - Robbie Sparrow AU - Shubrandu Sanjoy AU - Yun-Hee Choi AU - Islam Y Elgendy AU - Hani Jneid AU - Pedro A Villablanca AU - David R Holmes AU - Ashish Pershad AU - Chadi Alraies AU - Luciano A Sposato AU - Mamas A Mamas AU - Rodrigo Bagur Y1 - 2021/12/01 UR - http://heart.bmj.com/content/107/24/1946.abstract N2 - Objective This manuscript aims to explore the impact of race/ethnicity and socioeconomic status on in-hospital complication rates after left atrial appendage closure (LAAC).Methods The US National Inpatient Sample was used to identify hospitalisations for LAAC between 1 October 2015 to 31 December 2018. These patients were stratified by race/ethnicity and quartiles of median neighbourhood income. The primary outcome was the occurrence of in-hospital major adverse events, defined as a composite of postprocedural bleeding, cardiac and vascular complications, acute kidney injury and ischaemic stroke.Results Of 6478 unweighted hospitalisations for LAAC, 58% were male and patients of black, Hispanic and ‘other’ race/ethnicity each comprised approximately 5% of the cohort. Adjusted by the older Americans population, the estimated number of LAAC procedures was 69.2/100 000 for white individuals, as compared with 29.5/100 000 for blacks, 47.2/100 000 for Hispanics and 40.7/100 000 for individuals of ‘other’ race/ethnicity. Black patients were ~5 years younger but had a higher comorbidity burden. The primary outcome occurred in 5% of patients and differed significantly between racial/ethnic groups (p<0.001) but not across neighbourhood income quartiles (p=0.88). After multilevel modelling, the overall rate of in-hospital major adverse events was higher in black patients as compared with whites (OR: 1.60, 95% CI 1.22 to 2.10, p<0.001); however, the incidence of acute kidney injury was higher in Hispanics (OR: 2.19, 95% CI 1.52 to 3.17, p<0.001). No significant differences were found in adjusted overall in-hospital complication rates between income quartiles.Conclusion In this study assessing racial/ethnic disparities in patients undergoing LAAC, minorities are under-represented, specifically patients of black race/ethnicity. Compared with whites, black patients had higher comorbidity burden and higher rates of in-hospital complications. Lower socioeconomic status was not associated with complication rates.All data relevant to the study are included in the article or uploaded as supplementary information. ER -