Racial and ethnic differences were not associated with late presentation or adverse outcomes in patients with coarctation of the aorta (CoA) undergoing transcatheter coarctation repair (TCR); however, higher median household income was independently associated with less risk of adverse outcomes, according to a recent study published in the American Journal of Cardiology.

Including 2,267 patients (aged ≥16 years) from ACC's IMPACT Registry between 2011 and 2023, Katia Bravo-Jaimes, MD, FACC, et al., sought to identify racial and ethnic differences in presentation and outcomes. They note an underrepresentation of Hispanic and Non-Hispanic Black patients in their data, with 70.9% classified as Non-Hispanic White, 18.5% Hispanic, 7.4% Non-Hispanic Black and 3.3% Non-Hispanic Other.

Late CoA presentation was observed in 53.6% of patients, with no difference across racial and ethnic groups (p=0.076). The only independent predictor of late presentation was older age (odds ratio [OR], 1.25, 95% CI, 1.13-1.40; p<0.001). Adult-based hospitals saw more late presentation than pediatric-based hospitals (60.1% vs. 48.6%, p<0.001), and there was no association between late presentation and hospital volume.

Overall, 8.8% of patients experienced adverse TCR outcomes with similar rates across racial and ethnic groups (p=0.392). There was no difference in outcomes by hospital type, TCR volume or Adult Congenital Heart Association (ACHA) accreditation status; however, patients with a higher median household income were less likely to suffer adverse events (OR, 0.78, 95% CI, 0.62-0.97; p=0.027). Additionally, sensitivity analyses found that in-hospital mortality was higher among patients who were not White (0.6% vs. 0.1%, p=0.012).

"These results highlight the safety of TCR in a real-world setting despite late presentation and are a call to action for improved CoA screening and equitable high-quality care; especially among ACHA-accredited centers; strengthening networks between community cardiologists and Adult Congenital Heart Disease centers and supporting future research to assess the value of community, employment and school-based hypertension screening in adolescents and adults," write the authors.