Differences in mitral valve disease presentation and surgical treatment outcome between Hispanic and non-Hispanic patients.
OBJECTIVE
This study analyzed the differences in clinical presentation, etiology, and hospital outcome between Hispanic and non-Hispanic patients who underwent surgical correction of mitral valve disease at a large urban medical center.


METHODS
All adult patients undergoing isolated mitral valve repair or replacement surgery at two hospitals between 1993 and 2003 were studied. Patients were grouped according to ethnicity as reported to the New York State Cardiac Surgery Reporting System. Preoperative variables compared included age, congestive heart failure (CHF), etiology, and pertinent medical and surgical histories, while perioperative variables included type of operation, mortality, and hospital complications.


RESULTS
A total of 1683 patients (135 Hispanic,1548 non-Hispanic) underwent mitral valve surgery. Hispanic patients were younger (48.3+/-16.0 vs 59.7+/-15.9 years, P<.001) and had higher incidences of CHF (48.9% vs 35.3%, P=.002), endocarditis (8.9% vs 5.0%, P=.05), and rheumatic disease (12.6% vs 5.4%, P<.001). Non-Hispanic patients had a higher incidence of degenerative disease (68.0% vs 54.8%, P<.01). No differences in hospital mortality (Hispanic 5.9% vs 5.3%, P=.76) or perioperative complications were observed between the two groups, although Hispanic patients were less likely to undergo mitral valve repair than mitral valve replacement (35.6% vs 61.2%, P<.001).


CONCLUSIONS
In the urban population studied, Hispanic patients presented for mitral valve surgery at a younger age and with a higher prevalence of CHF and rheumatic disease. Public health strategies to prevent rheumatic fever among Hispanics are needed, and improved screening might facilitate earlier referral for Hispanic patients, increasing the potential for benefitting from mitral valve repair.
DiGiorgi
Paul L
PL
Department of Cardiothoracic Surgery, New York University School of Medicine, New York, New York, USA.
Baumann
F Gregory
FG
O'Leary
Anne M
AM
Schwartz
Charles F
CF
Grossi
Eugene A
EA
Ribakove
Greg H
GH
Colvin
Stephen B
SB
Galloway
Aubrey C
AC
Grau
Juan B
JB
D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006349:Heart Valve Diseases / Q000208:ethnology* / Q000209:etiology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D017052:Hospital Mortality / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome