{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:13:03Z","timestamp":1788930783534,"version":"build-2803163510"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,12,20]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Racial and ethnic minority groups are underrepresented among patients undergoing aortic valve replacement in the United States. We evaluated the impact of race and ethnicity on the diagnosis of aortic stenosis (AS).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In patients with transthoracic echocardiography (TTE)\u2010confirmed AS, we assessed rates of AS diagnosis as defined by assignment of an\n              <jats:italic>International Classification of Diseases, Ninth Revision (ICD\u20109)<\/jats:italic>\n              and\n              <jats:italic>Tenth Revision (ICD\u201010)<\/jats:italic>\n              code for AS within a large multicenter electronic health record. Multivariable Cox proportional hazard and competing risk regression models were used to evaluate the 1\u2010year rate of AS diagnosis by race and ethnicity. Among 14\u2009800 patients with AS, the 1\u2010year diagnosis rate for AS following TTE was 37.4%. Increasing AS severity was associated with an increased likelihood of receiving an AS diagnosis (moderate: hazard ratio [HR], 3.05 [95% CI, 2.86\u20133.25];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001; severe: HR, 4.82 [95% CI, 4.41\u20135.28];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). Compared with non\u2010Hispanic White, non\u2010Hispanic Black (HR, 0.65 [95% CI, 0.54\u20130.77];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) and non\u2010Hispanic Asian individuals (HR, 0.72 [95% CI, 0.57\u20130.90],\n              <jats:italic>P<\/jats:italic>\n              =0.004) were less likely to receive a diagnosis of AS. Additional factors associated with a decreased likelihood of receiving an AS diagnosis included a noncardiology TTE ordering provider (HR, 0.92 [95% CI, 0.86\u20130.97];\n              <jats:italic>P<\/jats:italic>\n              =0.005) and TTE performed in the inpatient setting (HR, 0.72 [95% CI, 0.66\u20130.78];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Rates of receiving an\n              <jats:italic>ICD<\/jats:italic>\n              diagnostic code for AS following a diagnostic TTE are low and vary significantly by race and ethnicity and disease severity. Further studies are needed to determine if efforts to maximize the clinical recognition of TTE\u2010confirmed AS may help to mitigate disparities in treatment.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.025692","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T10:53:40Z","timestamp":1671447220000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Racial and Ethnic Differences in the Clinical Diagnosis of Aortic Stenosis"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8403-2445","authenticated-orcid":false,"given":"Daniela R.","family":"Crousillat","sequence":"first","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital Harvard Medical School Boston MA"},{"name":"Division of Cardiovascular Sciences University of South Florida Tampa 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MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devavrat","family":"Bapat","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7811-4030","authenticated-orcid":false,"given":"Chen","family":"Chen","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1540-3772","authenticated-orcid":false,"given":"Alexandra","family":"Selberg","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Shaqdan","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varsha K.","family":"Tanguturi","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9264-3243","authenticated-orcid":false,"given":"Michael H.","family":"Picard","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3737-7584","authenticated-orcid":false,"given":"Judy W.","family":"Hung","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8013-8733","authenticated-orcid":false,"given":"Sammy","family":"Elmariah","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital Harvard Medical School Boston MA"},{"name":"Cardiology Division University of California San Francisco San Francisco 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