{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T20:26:11Z","timestamp":1789244771582,"version":"build-2803163510"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,6,3]]},"abstract":"<jats:sec id=\"jah311041-sec-0001\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Despite the slowly progressive nature of aortic stenosis, a proportion of aortic valve replacements (AVRs) still occur on an urgent\/emergent basis. We sought to characterize the predictors, outcomes, and potential opportunities to prevent urgent\/emergent AVRs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah311041-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">We analyzed Medicare data to identify patients undergoing AVRs from 2017 to 2022. We used multivariable regression to identify factors associated with nonelective AVRs; we also examined the association of nonelective AVRs with clinical outcomes and health care costs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah311041-sec-0003\" xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">In total, 15\u2009305 patients (16% urgent\/emergent) underwent AVR during the study period. Compared with patients undergoing elective AVRs, those receiving urgent\/emergent AVRs were more frequently of Black race or Hispanic ethnicity, and less likely to have received a diagnosis of aortic stenosis, despite 91.7% having seen a cardiologist or primary care provider in the prior year. In multivariable\u2010adjusted analyses, dual Medicare\u2013Medicaid enrollment, male sex, and recent heart failure hospitalization were associated with increased risk for urgent\/emergent AVR; conversely, recent aortic stenosis diagnosis and cardiologist visit were associated with lower odds of urgent\/emergent AVR. In turn, urgent\/emergent compared with elective AVR increased risk for in\u2010hospital death, intensive care unit admission, and discharge to a facility versus home, in addition to longer lengths of stay and higher health care costs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah311041-sec-0004\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Urgent\/emergent AVR occurs more frequently among Black, Hispanic, and dual Medicare\u2013Medicaid\u2010eligible patients. Nonelective AVR is also associated with worse hospital outcomes as well as greater health care costs. Importantly, variable timing in diagnosis of aortic stenosis appears to be a key determinant; thus, augmented screening efforts may improve outcomes and reduce disparities.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.125.041148","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T11:13:38Z","timestamp":1748517218000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Differential Characteristics and Outcomes of Urgent\/Emergent Versus Elective Aortic Valve Replacement"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0587-1572","authenticated-orcid":false,"given":"Joseph E.","family":"Ebinger","sequence":"first","affiliation":[{"name":"Smidt Heart Institute, Cedars\u2010Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9103-9872","authenticated-orcid":false,"given":"Aakriti","family":"Gupta","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute, Cedars\u2010Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8793-847X","authenticated-orcid":false,"given":"Tzu Yu","family":"Huang","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute, Cedars\u2010Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella A.","family":"Kelley","sequence":"additional","affiliation":[{"name":"Edwards Lifesciences","place":["Irvine, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4713-4730","authenticated-orcid":false,"given":"Christin","family":"Thompson","sequence":"additional","affiliation":[{"name":"Edwards Lifesciences","place":["Irvine, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7549-9127","authenticated-orcid":false,"given":"Maria","family":"Platanis","sequence":"additional","affiliation":[{"name":"Edwards Lifesciences","place":["Irvine, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4977-036X","authenticated-orcid":false,"given":"Susan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute, Cedars\u2010Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2016.10.005"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.104.495903"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2021-319025"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.894170"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/circresaha.113.300156"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.11.060"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.09.855"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.680123"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009195"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.19801"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/00033197241245733"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.03.002"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.shj.2023.100166"},{"key":"e_1_3_1_15_2","unstructured":"Research Data Assistance Center . 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