Abdullah Haddad

and 13 more

Introduction: Non-white patients are underrepresented in left atrial appendage occlusion (LAAO) trials, and racial disparities in LAAO periprocedural management are unknown. Methods: We assessed sociodemographics and comorbidities of consecutive patients at our institution undergoing LAAO between 2015 – 2020, then in adjusted analyses, compared procedural wait time, procedural complications, and post-procedure oral anticoagulation (OAC) use in whites versus non-whites. Results: Among 109 patients undergoing LAAO (45% white), whites were less likely to have heart failure than non-whites (18% vs. 48%, p=0.001), prior stroke (14% vs. 43%, p=0.001), or end stage renal disease (0 vs. 20%, p<0.001). Whites had lower CHA2DS2VASc scores, on average (4.0 vs. 4.8, p=0.006). There was no difference in median time from index event or initial outpatient cardiology encounter to LAAO procedure (whites 10.5 vs. non-whites 13.7 months, p=0.9; 1.9 vs 1.8 months, p=0.6, respectively), and there was no difference in procedural complications (whites 4% vs. non-whites 5%, p=0.33). After adjusting for CHA2DS2VASc score, OAC use at discharge tended to be higher in whites (OR 2.4, 95%CI [0.9-6.0], p=0.07). When restricting the analysis to those with prior gastrointestinal (GI) bleed, adjusting for CHA2DS2VASc score and GI bleed severity, whites had a nearly five-fold odds of being discharged on OAC (OR 4.6, 95% CI [1-21.8], p=0.05). Conclusion: Despite an increased prevalence of comorbidities amongst non-whites, wait time for LAAO and procedural complications were similar in whites versus non-whites. Among those with prior GI bleed, whites were nearly five-fold more likely to be discharged on OAC than non-whites.