{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T08:20:04Z","timestamp":1778055604176,"version":"3.51.4"},"reference-count":30,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T00:00:00Z","timestamp":1683504000000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2023,4,14]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To explore the ethnic differences in patients undergoing aortic valve (AV) intervention for severe aortic stenosis (AS) in Leicestershire, UK.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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\u2009years younger, respectively, than white patients with more comorbidities and a worse functional status.<\/jats:p>\n                  <jats:p>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\u20130.87) and 0.27 (0.18\u20130.43), respectively, but the age-adjusted RR was not statistically significant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2023-002266","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T10:56:53Z","timestamp":1683543413000},"page":"e002266","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Aortic valve intervention rates in patients of different ethnicity with severe aortic stenosis in Leicestershire, UK"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8370-186X","authenticated-orcid":false,"given":"Saadia","family":"Aslam","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8232-3986","authenticated-orcid":false,"given":"Michalis A","family":"Patsalides","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svetlana","family":"Stoma","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aseel","family":"Alfuhied","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher P","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6282-4318","authenticated-orcid":false,"given":"Iain B","family":"Squire","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0127-5236","authenticated-orcid":false,"given":"Claire A","family":"Lawson","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamlesh","family":"Khunti","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre, University of Leicester, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5542-8448","authenticated-orcid":false,"given":"Gerry P","family":"McCann","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anvesha","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,5,8]]},"reference":[{"key":"2025081710222994000_10.1.e002266.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.015"},{"key":"2025081710222994000_10.1.e002266.2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2019-314940"},{"key":"2025081710222994000_10.1.e002266.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.041080"},{"key":"2025081710222994000_10.1.e002266.4","first-page":"149","article-title":"Racial and ethnic differences in treatment and outcomes of severe aortic stenosis","volume":"13","author":"Wilson","year":"2020","journal-title":"JACC: Cardiovascular Interventions"},{"key":"2025081710222994000_10.1.e002266.5","first-page":"980","article-title":"Sex and race differences in the pathophysiology, diagnosis, treatment, and outcomes of valvular heart diseases","volume":"37","author":"Fleury","year":"2021","journal-title":"Can J Cardiol"},{"key":"2025081710222994000_10.1.e002266.6","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.carrev.2021.06.120","article-title":"Racial and ethnic disparities in the use of transcatheter aortic valve replacement in the state of Connecticut","volume":"37","author":"Ali","year":"2022","journal-title":"Cardiovasc Revasc Med"},{"key":"2025081710222994000_10.1.e002266.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.05.030"},{"key":"2025081710222994000_10.1.e002266.8","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.jacc.2021.04.078","article-title":"Race\/ethnicity and prevalence of aortic stenosis by echocardiography in the multi-ethnic study of atherosclerosis","volume":"78","author":"Czarny","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2025081710222994000_10.1.e002266.9","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1001\/jama.2022.5776","article-title":"Effect of transcatheter aortic valve implantation vs surgical aortic valve replacement on all-cause mortality in patients with aortic stenosis: a randomized clinical trial","volume":"327","author":"Investigators","year":"2022","journal-title":"JAMA"},{"key":"2025081710222994000_10.1.e002266.10","unstructured":"ONS . Ethnic group by sex and age (table LC2101EW). 2011. Available: https:\/\/www.nomisweb.co.uk\/census\/2011\/lc2101ew"},{"key":"2025081710222994000_10.1.e002266.11","unstructured":"ONS . Table KS201UK. 2011. Available: https:\/\/www.nomisweb.co.uk\/census\/2011\/ks201uk"},{"key":"2025081710222994000_10.1.e002266.12","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-312374"},{"key":"2025081710222994000_10.1.e002266.13","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2019-315978"},{"key":"2025081710222994000_10.1.e002266.14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1963.03060120024016"},{"key":"2025081710222994000_10.1.e002266.15","doi-asserted-by":"publisher","DOI":"10.5770\/cgj.23.463"},{"key":"2025081710222994000_10.1.e002266.16","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezs043"},{"key":"2025081710222994000_10.1.e002266.17","doi-asserted-by":"crossref","first-page":"e270","DOI":"10.1093\/pubmed\/fdaa198","article-title":"The need for improved collection and coding of ethnicity in health research","volume":"43","author":"Khunti","year":"2021","journal-title":"J Public Health (Oxf)"},{"key":"2025081710222994000_10.1.e002266.18","first-page":"719","article-title":"Statistical aspects of the analysis of data from retrospective studies of disease","volume":"22","author":"MANTEL","year":"1959","journal-title":"J Natl Cancer Inst"},{"key":"2025081710222994000_10.1.e002266.19","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/j.amjcard.2017.04.048","article-title":"Comparison of frequency of referral to cardiothoracic surgery for aortic valve disease in blacks, Hispanics, and whites","volume":"120","author":"Cruz Rodriguez","year":"2017","journal-title":"Am J Cardiol"},{"key":"2025081710222994000_10.1.e002266.20","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(99)00338-X"},{"key":"2025081710222994000_10.1.e002266.21","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.5.479"},{"key":"2025081710222994000_10.1.e002266.22","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1111\/hsc.12384","article-title":"Inequity in cardiovascular care in the English National health service (NHS): a scoping review of the literature","volume":"26","author":"Asthana","year":"2018","journal-title":"Health Soc Care Community"},{"key":"2025081710222994000_10.1.e002266.23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0270775","article-title":"Ethnic inequalities in patient satisfaction with primary health care in England: evidence from recent general practitioner patient surveys (GPPS)","volume":"17","author":"Magadi","year":"2022","journal-title":"PLoS One"},{"key":"2025081710222994000_10.1.e002266.24","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw229"},{"key":"2025081710222994000_10.1.e002266.25","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.114.000879","article-title":"Racial differences in the prevalence of severe aortic stenosis","volume":"3","author":"Patel","year":"2014","journal-title":"J Am Heart Assoc"},{"key":"2025081710222994000_10.1.e002266.26","first-page":"10","article-title":"Epidemiology of aortic valve stenosis (as) and of aortic valve incompetence (AI): is the prevalence of AS\/AI similar in different parts of the world?","volume":"18","year":"2020","journal-title":"E-Journal of Cardiology Practice"},{"key":"2025081710222994000_10.1.e002266.27","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.ihj.2020.06.013","article-title":"Etiology and distribution of isolated aortic stenosis in Indian patients-a study from a large tertiary care hospital in North India","volume":"72","author":"Sahu","year":"2020","journal-title":"Indian Heart J"},{"key":"2025081710222994000_10.1.e002266.28","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.ihj.2014.03.010","article-title":"Incidence and patterns of valvular heart disease in a tertiary care high-volume cardiac center: a single center experience","volume":"66","author":"Manjunath","year":"2014","journal-title":"Indian Heart Journal"},{"key":"2025081710222994000_10.1.e002266.29","unstructured":"White C . Ethnic differences in life expectancy and mortality from selected causes in England and Wales: 2011 to 2014. Office for National Statistics, 2021."},{"key":"2025081710222994000_10.1.e002266.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.10.071"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2023-002266","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T17:22:41Z","timestamp":1755451361000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2023-002266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,5,8]]},"published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1136\/openhrt-2023-002266"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2023-002266","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]}}}