Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK.
Open Heart. 2023 May;10(1). doi: 10.1136/openhrt-2023-002266.
To explore the ethnic differences in patients undergoing aortic valve (AV) intervention for severe aortic stenosis (AS) in Leicestershire, UK.
Retrospective cohort study of all surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) at a single tertiary centre between April 2017 and March 2022, using local registry data.
Of the 1231 SAVR and 815 TAVI performed, 6.5% and 3.7% were in ethnic minority patients, respectively. Based on the 2011 Census data for those with a Leicestershire postcode, crude cumulative rate of SAVR (n=489) was 0.64 per 1000 population overall and 0.69, 0.46 and 0.36 in White, Asian and Black populations, respectively; and 0.50 per 1000 population overall for TAVI (n=383), with 0.59, 0.16 and 0.06 for White, Asian and Black populations, respectively. Asians undergoing SAVR and TAVI were 5 and 3 years younger, respectively, than white patients with more comorbidities and a worse functional status.The age-adjusted cumulative rates for SAVR were 0.62 vs 0.72 per 1000 population for White and Asian patients and 0.51 vs 0.39 for TAVI. Asians were less likely to undergo SAVR and TAVI than White patients, with a risk ratio (RR) of 0.66 (0.50-0.87) and 0.27 (0.18-0.43), respectively, but the age-adjusted RR was not statistically significant.
The crude rates of AV interventions are lower in Asian patients compared with the White population in Leicestershire, although age-adjusted rates were not statistically different. Further research to determine the sociodemographic differences in prevalence, incidence, mechanisms and treatment of AS across the UK is required.
探讨英国莱斯特郡行主动脉瓣（AV）干预严重主动脉瓣狭窄（AS）的患者的民族差异。
回顾性队列研究，纳入 2017 年 4 月至 2022 年 3 月在一家三级中心行外科主动脉瓣置换术（SAVR）和经导管主动脉瓣植入术（TAVI）的所有患者，使用当地登记数据。
在 1231 例 SAVR 和 815 例 TAVI 中，少数民族患者分别占 6.5%和 3.7%。根据莱斯特郡邮编的 2011 年人口普查数据，总体人群中 SAVR（n=489）的粗累积率为 0.64/1000 人，白人、亚洲人和黑人人群分别为 0.69、0.46 和 0.36；总体人群中 TAVI（n=383）的累积率为 0.50/1000 人，白人、亚洲人和黑人人群分别为 0.59、0.16 和 0.06。行 SAVR 和 TAVI 的亚洲人比白人患者分别年轻 5 岁和 3 岁，且合并症更多，功能状态更差。校正年龄后，SAVR 的累积率为白人患者 0.62/1000 人，亚洲患者 0.72/1000 人；TAVI 的累积率为白人患者 0.51/1000 人，亚洲患者 0.39/1000 人。与白人患者相比，亚洲患者行 SAVR 和 TAVI 的可能性较小，风险比（RR）分别为 0.66（0.50-0.87）和 0.27（0.18-0.43），但校正年龄后的 RR 无统计学意义。
与莱斯特郡的白人人群相比，亚洲患者行 AV 干预的粗率较低，尽管校正年龄后的率无统计学差异。需要进一步研究以确定英国各地 AS 的患病率、发病率、机制和治疗的社会人口学差异。
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