Abstract 16792: Gender Differences in African Americans and Caucasians With Severe Aortic Stenosis or Bicuspid Aortic Valve

Abstract

Introduction: Severe aortic stenosis (AS) is a multifactorial, progressive condition that is associated with high short-term mortality. Risk factors for mortality have been described and include male sex, hypertension, hyperlipidemia, and congenital bicuspid valve (BAV). Senile, calcific AS is thought to affect both genders equally in contrast to BAV which has a 3:1 male preponderance. It is unknown if there are gender differences in the prevalence of severe, senile AS or congenital bicuspid aortic valve in Whites compared to Blacks. Methods: 10,299 Black or White patients with severe aortic stenosis or bicuspid aortic valve treated at Cleveland Clinic with primary AVR from 1/1/2000 to 1/1/2017 were included in this study. There were 257 Black patients (2.5% of the study population). Categorical data on gender was compared using the Chi-squared test. Results: Blacks with severe aortic stenosis were significantly more likely to be female compared to Caucasians (55% vs 36%, p<0.001). There were no differences in gender prevalence among patients with BAV (73% vs 74%, p=0.88). Conclusions: Our study found that Blacks with severe AS undergoing AVR are significantly more likely to be female compared to Whites. However, there were no differences in gender prevalence among Blacks and Whites with BAVs. Although Black men are the least likely demographic to access health care, they comprise the majority of the BAV group. Thus, lack of health care access does not fully explain the gender differences in the severe AS group. There may be a strong underlying genetic component accounting for the 3:1 male predominance in all BAV patients.