Cardiovasc Revasc Med
· 2026 Jun · PMID 42248765
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BACKGROUND: Post-procedural high-sensitivity cardiac troponin T (hs-TnT) is an established prognostic marker after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), yet its prognostic value may...BACKGROUND: Post-procedural high-sensitivity cardiac troponin T (hs-TnT) is an established prognostic marker after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), yet its prognostic value may not be uniform across age groups, particularly when mortality and ischemic endpoints are considered separately. METHODS: From a prospective PCI registry (March 2016-March 2019), 14,210 ACS patients were stratified by age (<65 vs ≥65 years) and post-procedural hs-TnT (<5× vs ≥5× upper reference limit). The primary endpoint was 12-month all-cause mortality; the secondary endpoint was ischemic events (cardiac death, myocardial infarction, or stroke). Age × hs-TnT interaction was assessed using multivariable Cox models and tensor product restricted cubic spline models. RESULTS: At 12 months, 221 deaths and 312 ischemic events occurred. Elevated hs-TnT was associated with increased mortality in patients aged ≥65 (adjusted hazard ratio [aHR], 2.80; 95% CI, 1.84-4.27) but not in those aged <65 (aHR, 1.25; 95% CI, 0.75-2.07; P for interaction = 0.006). A concordant pattern was observed for cardiac death (P for interaction = 0.020). In contrast, elevated hs-TnT predicted ischemic events equally regardless of age (aged <65: aHR, 2.18; aged ≥65: aHR, 2.17; P for interaction = 0.995). Tensor product analysis confirmed a significant interaction for mortality (P = 0.048) but not for ischemic events (P = 0.935). CONCLUSIONS: Age selectively modified the prognostic value of post-procedural hs-TnT for mortality, but not for ischemic events, in patients with ACS undergoing PCI. Age-stratified interpretation of post-procedural hs-TnT may improve post-PCI risk stratification if externally validated.
Endo T, Saito K, Sakai S
… +2 more, Horiuchi D, Matsui H
Cardiovasc Revasc Med
· 2026 May · PMID 42236411
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BACKGROUND: Side branch compromise remains a major limitation of percutaneous coronary intervention for coronary bifurcation lesions. Drug-coated balloon (DCB)-based strategies may preserve bifurcation geometry by avoidi...BACKGROUND: Side branch compromise remains a major limitation of percutaneous coronary intervention for coronary bifurcation lesions. Drug-coated balloon (DCB)-based strategies may preserve bifurcation geometry by avoiding permanent metallic scaffolds. AIMS: To compare side branch-related events between DCB- and drug-eluting stent (DES)-based strategies. METHODS: We retrospectively analyzed 340 patients with coronary bifurcation lesions treated using either a DCB-based strategy (n = 140) or a DES-based strategy (n = 200). The primary endpoint was any side branch-related event, defined as side branch occlusion or significant flow deterioration. Secondary endpoints included major adverse cardiac events (MACE) at 6 months and 1 year. Propensity score matching was performed. RESULTS: The DCB group had more severe calcification and more frequent debulking device use. Side branch rewiring was less frequent in the DCB group (2.3% vs. 23.2%, P < 0.001). Side branch-related events were lower with DCB than DES (3.1% vs. 14.7%, P = 0.001). Side branch occlusion (0.8% vs. 6.2%, P = 0.018) and CK elevation associated with occlusion (0% vs. 5.4%, P = 0.007) were also reduced. MACE was lower at 6 months (0% vs. 5.4%, P = 0.007), but not at 1 year (3.9% vs. 8.5%, P = 0.121). After matching, 129 pairs were generated, with consistent findings. CONCLUSIONS: A DCB-based strategy was associated with fewer side branch-related events than a DES-based strategy. Avoiding permanent metallic scaffolds may help preserve side branch patency.
Khokhar A, Sohal S, Ambrosini A
… +7 more, Li F, Sangal RB, Possick S, Cigarroa N, Odanovic N, Kim N, Shah S
Cardiovasc Revasc Med
· 2026 May · PMID 42230218
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BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) is widely used for risk stratification in patients presenting with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS). However, the extent to which ele...BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) is widely used for risk stratification in patients presenting with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS). However, the extent to which elevated or rising hs-cTnT values predict obstructive coronary artery disease (CAD) in patients referred for invasive coronary angiography (ICA) is not well described. METHODS: We performed a retrospective analysis of consecutive patients with NSTE-ACS across a large multi-hospital health system who underwent hs-cTnT testing and ICA during the same episode of care. Clinical characteristics, hs-cTnT measurements, and noninvasive and invasive diagnostic findings were evaluated. The association between hs-cTnT values and obstructive CAD was assessed using logistic regression and receiver-operating characteristic (ROC) analysis. RESULTS: Among 728 patients with elevated hs-cTnT, obstructive CAD was identified in 413 (57%), whereas 312 (43%) had non-obstructive coronary artery disease. Initial hs-cTnT levels were significantly higher in patients with obstructive CAD compared with those without (201.1 ± 449.9 ng/L vs. 78.8 ± 189.6 ng/L; p < 0.001). In contrast, 1-hour and 3-hour delta hs-cTnT values were not associated with obstructive CAD. The initial hs-cTnT demonstrated modest discrimination for obstructive CAD (AUC 0.64), with sex-specific optimal thresholds of 64 ng/L for females and 48 ng/L for males. Model performance improved (AUC 0.72) when adjusted for demographic and cardiovascular risk factors. CONCLUSION: In patients with NSTE-ACS referred for ICA, elevated hs-cTnT alone has limited "rule-in" value for identifying obstructive CAD. Initial hs-cTnT levels modestly predicted obstructive CAD, whereas serial hs-cTnT changes provided no incremental diagnostic value. Incorporating demographic and clinical risk factors significantly improved the identification of obstructive CAD in this population.
Morishita T, Uzui H, Sato Y
… +4 more, Shimizu T, Kataoka T, Hasegawa K, Tada H
Cardiovasc Revasc Med
· 2026 May · PMID 42209383
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The SYNTAX score allows risk stratification of patients undergoing percutaneous coronary intervention (PCI). However, its applicability in Asian populations, particularly in real-world settings involving aging patients,...The SYNTAX score allows risk stratification of patients undergoing percutaneous coronary intervention (PCI). However, its applicability in Asian populations, particularly in real-world settings involving aging patients, remains unclear. In this study, we validated the ability of the SYNTAX score to predict major adverse cardiac and cerebrovascular events (MACE) in an all-comer Japanese population undergoing PCI. We retrospectively analyzed 1104 patients with coronary artery disease who underwent PCI between 2006 and 2016 at a tertiary care center in Japan, including 828 patients with available 1-year follow-up data. Patients were stratified into low- (≤22), intermediate- (23-32), and high- (≥33) risk groups based on their SYNTAX scores. The primary endpoint was the 4-point MACE. Model discrimination was assessed using the area under the receiver operating characteristic curve and calibration was evaluated using calibration plots with bootstrap validation. During the 1-year follow-up period, 194 MACE (23%) occurred. Kaplan-Meier analysis revealed significant differences in MACE-free survival among the risk groups (log-rank P < 0.01). Cox proportional hazard models revealed that the intermediate- and high-risk groups had significantly higher MACE risks than the low-risk group. Restricted cubic spline analysis demonstrated an approximately linear association between the SYNTAX score and MACE risk. The model exhibited modest discrimination and calibration after bootstrap validation, thereby supporting its moderate predictive accuracy. The SYNTAX score maintained its predictive value over an extended 4-year follow-up period. In conclusion, the SYNTAX score effectively predicted both short- and long-term MACE risks in a Japanese all-comer PCI population, suggesting its validity in a real-world setting. CLINICAL TRIAL REGISTRATION NUMBER: UMIN000023837.
Cardiovasc Revasc Med
· 2026 May · PMID 42203571
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BACKGROUND: Current endovascular strategies for stroke prevention in atrial fibrillation (AF) rely on permanent metallic implants to occlude the Left Atrial Appendage (LAA). However, these implants are associated with ri...BACKGROUND: Current endovascular strategies for stroke prevention in atrial fibrillation (AF) rely on permanent metallic implants to occlude the Left Atrial Appendage (LAA). However, these implants are associated with risks such as device-related thrombus, peri-device leaks, and embolization. We evaluated the safety and feasibility of a novel, implant-free transcatheter system designed to eliminate the LAA via mechanical inversion and ligation. METHODS: The Append System utilizes a vacuum-assisted tissue grabber to invert the LAA into the left atrium and a ligation assembly to suture the base, preventing evagination. Six canines (mean weight 29.3 ± 2.0 kg) underwent transfemoral LAA invagination. Follow-up assessments included Transesophageal Echocardiography (TEE), Computed Tomography (CT), and histopathology at 30 days (n = 2) and 90 days (n = 4). RESULTS: Procedural success was 100% (6/6) with no hemodynamic instability, pericardial effusion, or mitral valve injury. Despite variable ostial anatomy (mean 18.1 ± 2.2 mm), a single-sized device was effective in all subjects. Follow-up TEE and CT imaging confirmed complete elimination of the LAA lumen in all animals. The invaginated tissue formed an intra-atrial mass that remodeled significantly, reducing in length from 19.3 ± 1.6 mm at baseline to 11.2 ± 2.8 mm at 90 days (p < 0.05). Histopathology demonstrated preserved endothelial integrity, fibrosis, and neovascularization without thrombus formation. CONCLUSIONS: This pre-clinical study demonstrates the feasibility and preliminary safety of the Append system for transseptal LAA elimination. By utilizing invagination and suture ligation, this approach offers a promising potential implant-free alternative for stroke prevention in atrial fibrillation.
Sanfilippo C, Frazzetto M, Pelliccia M
… +10 more, Giacalone C, Contrafatto C, Briguglio F, Gurgoglione FL, Leonforte F, Attizzani G, Esteves V, Filby SJ, Grasso C, Tamburino C
Cardiovasc Revasc Med
· 2026 May · PMID 42120274
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Peridevice leaks (PDL) represent a frequent finding following left atrial appendage occlusion (LAAO) procedures, despite continuous improvements in device design, implantation techniques, and imaging modalities. The dete...Peridevice leaks (PDL) represent a frequent finding following left atrial appendage occlusion (LAAO) procedures, despite continuous improvements in device design, implantation techniques, and imaging modalities. The detection, incidence, and clinical relevance vary widely depending on anatomical factors, patient characteristics, device type, and the imaging modality used. While transoesophageal echocardiography (TEE) remains the standard of care for post-procedural device surveillance, cardiac computed tomography angiography (CCTA) has shown higher sensitivity in identifying residual leaks. Although small PDL have often been considered clinically irrelevant, recent data suggest a potential association with increased risk of thromboembolic events. The size and location of the leak, as well as its evolution over time, appear to play a key role in determining clinical outcomes. Device selection, pre-procedural planning, and optimal procedural technique are essential in minimizing leak formation. In cases of clinically significant PDL, especially when anticoagulation is contraindicated, interventional closure using vascular plugs, embolization coils, or radiofrequency ablation has emerged as a viable strategy. However, management remains individualized and evidence from randomized studies is limited. Further research is needed to better define the prognostic implications of PDL and establish standardized diagnostic and therapeutic algorithms aimed to improve patient outcomes after LAAO.
Advancements in transcatheter tricuspid valve intervention (TTVI) technology have yielded meaningful improvements in quality-of-life (QOL) for patients with tricuspid regurgitation (TR). The recent Food and Drug Administ...Advancements in transcatheter tricuspid valve intervention (TTVI) technology have yielded meaningful improvements in quality-of-life (QOL) for patients with tricuspid regurgitation (TR). The recent Food and Drug Administration (FDA) approval of two TTVI devices, TriClip and EVOQUE, has prompted extensive discussion regarding patient selection, device preference, and optimal timing of intervention. A dedicated session titled "Beyond the Guidelines: Tricuspid repair, replacement, medical therapy" was convened to examine clinical scenarios not adequately addressed by existing guidelines. This review summarizes the key observations and expert panel discussion to identify evidence gaps and inform the framework for future guideline development.
PURPOSE: To characterize the spectrum and distribution of adverse events and device malfunctions associated with guide catheter extensions (GCEs) reported to the FDA's Manufacturer and User Facility Device Experience (MA...PURPOSE: To characterize the spectrum and distribution of adverse events and device malfunctions associated with guide catheter extensions (GCEs) reported to the FDA's Manufacturer and User Facility Device Experience (MAUDE) database from 2022 to 2025. METHODS: We performed a retrospective analysis of all MAUDE reports submitted between January 2022 and May 2025 involving four commercially available GCEs: GuideLiner (Teleflex), Guidezilla (Boston Scientific), TrapLiner (Teleflex), and Telescope (Medtronic). Each MAUDE submission was defined as a "report," while individual device malfunctions or patient complications documented within a report were defined as "events"; a single report could contain multiple events. Prior to data extraction, categories for device-related events (advancement difficulty, structural breakage, material separation, dislodgment, deformation, and device-device incompatibility) and patient-related events (dissection, perforation, device embedding, embolism, hematoma, and myocardial infarction) were pre-specified on the basis of prior literature and FDA device problem codes. Patient-related events were further stratified as major or minor complications. Two investigators independently reviewed MAUDE narratives and classified events; discrepancies were resolved by consensus. All percentages represent the proportion of events within each device's total event count. Because the MAUDE database does not capture total device usage, true complication rates cannot be calculated, and comparative device safety cannot be assessed. RESULTS: A total of 363 reports containing 867 events were identified. Of these, 450 (51.9%) were device-related events and 417 (48.1%) were patient-related events. Among device-related events, Guidezilla accounted for the largest proportion (n = 295; 65.5%), followed by Telescope (n = 120; 26.6%), TrapLiner (n = 23; 5.1%), and GuideLiner (n = 12; 2.6%). Predominant failure modes varied by device: advancement difficulty (22.0%) and structural breakage (17.3%) for Guidezilla; material separation (56.5%) and material splits, cuts, or tears (17.4%) for TrapLiner; device dislodgment (30.0%) and material deformation (17.5%) for Telescope; and material separation (25.0%) and device-device incompatibility (25.0%) for GuideLiner. Among patient-related events, clinically significant major complications included vascular dissection (7.7% of GuideLiner and 3.9% of Guidezilla patient-related events), device embedding in tissue (9.3% of Telescope patient-related events), and rare occurrences of foreign body embolism, perforation, and myocardial infarction, primarily associated with TrapLiner and Telescope. A substantial proportion of reports did not describe associated clinical complications, suggesting that many device malfunctions may have been managed without adverse patient outcomes. CONCLUSIONS: Guidezilla accounted for the largest number of GCE-related adverse event reports, a finding that may reflect its broader utilization in complex PCI rather than a higher complication rate. Each device demonstrated characteristic failure patterns. Although most reported events appeared non-serious, clinically significant complications-including vascular dissection, device embedding, and foreign body embolism-did occur. These findings describe reporting patterns and cannot establish true complication rates or comparative device safety. Operator familiarity with device-specific failure modes and adherence to evidence-based techniques remain essential for safe GCE use.
Besir B, Badwan O, Motairek I
… +4 more, Rosenzveig A, Tabaja C, Bruemmer D, Kapadia SR
Cardiovasc Revasc Med
· 2026 May · PMID 42106205
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BACKGROUND: Cardiovascular-kidney-metabolic (CKM) syndrome is characterized by the interactions among metabolic risk factors, chronic kidney disease (CKD), and cardiovascular disease (CVD). Stage 4 CKM is characterized b...BACKGROUND: Cardiovascular-kidney-metabolic (CKM) syndrome is characterized by the interactions among metabolic risk factors, chronic kidney disease (CKD), and cardiovascular disease (CVD). Stage 4 CKM is characterized by clinical CVD. Management of stage 4 CKM involves control of comorbidities, blood pressure, and statin therapy. OBJECTIVES: This study examines global patterns and demographic disparities in the use of statins and antihypertensives among patients with stage 4 CKM, and evaluates outcomes stratified by age, sex, and race. METHODS: This is a retrospective cohort of patients >30 of age with stage 4 CKM and low-density lipoprotein ≥100 mg/dL (2010-2019) from the TriNetX Network. Healthcare organizations that did not report medication use were excluded. Stage 4 CKM was defined as dyslipidemia, or hypertension, or diabetes, or CKD, with any form of CVD. Outcomes, including all-cause mortality and major acute cardiovascular events (MACE), were compared across subgroups using Kaplan-Meier survival analysis and Cox regression. RESULTS: 823,468 patients were included, 60% were taking statins. Females and white patients were less likely to take statins. All-cause mortality was 16% and MACE was 25% in the overall population at 5 years. Males had a higher mortality risk compared to females (HR: 1.09 (1.07-1.10)), and white patients had a lower mortality risk but a higher risk of MACE. CONCLUSIONS: Although blood pressure control and statins are recommended for patients with stage 4 CKM, only 60% of those patients are taking statins. Females and white patients are less likely to take statins, and males, older patients, and non-white patients have poorer outcomes.
Cheema MRS, Arshad A, Abbasi SUAM
… +12 more, Umar M, Hamid M, Kashif M, Chattha RR, Babar A, Khan MS, Javed S, Fatima S, Ismail Z, Jain H, Minhas AMK, Goldsweig AM
Cardiovasc Revasc Med
· 2026 May · PMID 42103561
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BACKGROUND: Aortic stenosis leads to adverse left ventricular remodeling; aortic valve replacement (AVR) remains the cornerstone of management. We evaluated clinical and echocardiographic outcomes with renin-angiotensin...BACKGROUND: Aortic stenosis leads to adverse left ventricular remodeling; aortic valve replacement (AVR) remains the cornerstone of management. We evaluated clinical and echocardiographic outcomes with renin-angiotensin system inhibitor (RASi) use in patients undergoing AVR. METHODS: Five electronic databases were systematically queried for studies comparing outcomes with and without RASi post-AVR. Outcomes were pooled using random-effects models to calculate risk ratios (RRs), mean differences, and standardized mean differences with 95% confidence intervals. Outcomes of interest included all-cause and cardiovascular mortality, heart failure, myocardial infarction, stroke/TIA, arrhythmias, pacemaker requirement, acute kidney injury, and echocardiographic parameters. RESULTS: Seventeen studies (16 observational, 1 RCT) including 44,935 patients [RASi: 20,723; no RASi: 24,212] were included. RASi use was associated with significantly reduced all-cause mortality (RR: 0.74; 95% CI: 0.65-0.83; p < 0.0001) and cardiovascular mortality (RR: 0.65; 95% CI: 0.49-0.85; p = 0.002), consistent across TAVR and SAVR subgroups. No significant differences were observed for heart failure, myocardial infarction, stroke, or pacemaker requirement. RASi did not increase acute kidney injury (p = 0.08) or major bleeding (p = 0.67). Echocardiographic outcomes, including peak aortic valve velocity and LV mass index, showed no significant differences between groups. CONCLUSIONS: In predominantly observational studies, RASi use following AVR is associated with lower all-cause and cardiovascular mortality without increasing major adverse clinical events. Survival benefits were not accompanied by consistent echocardiographic improvements. Given substantial heterogeneity and residual confounding inherent to observational data, prospective randomized trials are needed to confirm these associations. SOCIAL MEDIA ABSTRACT: Meta-analysis of 17 studies shows survival benefit with ACEI/ARB in the patients undergoing TAVR/SAVR, with no significant differences in HF, MI, stroke/TIA, AF, pacemaker, or echo outcomes.
BACKGROUND: Mitral transcatheter edge-to-edge repair (M-TEER) effectively reduces mitral regurgitation (MR), yet conventional metrics may incompletely capture myocardial recovery. Myocardial deformation imaging offers qu...BACKGROUND: Mitral transcatheter edge-to-edge repair (M-TEER) effectively reduces mitral regurgitation (MR), yet conventional metrics may incompletely capture myocardial recovery. Myocardial deformation imaging offers quantitative assessment of ventricular and atrial function and may provide mechanistic insight into clinical response. AIMS: To characterize longitudinal multichamber myocardial deformation recovery after M-TEER and examine its association with 1-year clinical improvement. METHODS: This single-center observational study included patients who underwent M-TEER with the MitraClip G4 system between January 2022 and January 2025. Echocardiography was performed at baseline, 30 days, and 1 year. Speckle-tracking analysis included left ventricular global longitudinal strain (LV GLS), right ventricular free-wall strain (RV-FWS), and left atrial reservoir strain (LARS). Clinical recovery was assessed using New York Heart Association (NYHA) class and Kansas City Cardiomyopathy Questionnaire overall summary score (KCCQ-OS). Mortality and heart failure hospitalization were recorded as descriptive 1-year outcomes. Associations between deformation recovery and clinical improvement were evaluated using correlation and multivariable regression models; exploratory event-stratified analyses were performed according to 1-year event status. RESULTS: Among 118 consecutive patients undergoing M-TEER, 92 (78.0%) had analyzable speckle-tracking studies and comprised the primary analysis cohort. Procedural success was 95.7%, with durable MR ≤2+ in 98% at 1 year. LV, LA, and pulmonary pressure indices improved significantly over follow-up (all p < 0.001), whereas left ventricular ejection fraction (LVEF) remained unchanged. LV GLS, RV-FWS, and LARS improved significantly from baseline to 1 year (all p < 0.001). Improvements in LV GLS, RV-FWS, and LARS correlated with NYHA improvement and KCCQ-OS gain (all p ≤ 0.001). In multivariable models, LARS (β = 1.9 points per 1% increase, p < 0.001) and LV GLS (β = 2.6 points per 1% improvement, p = 0.002) remained independently associated with greater health-status improvement and materially improved the explanatory performance of the clinical model. CONCLUSIONS: Myocardial deformation analysis after M-TEER identifies multichamber functional recovery and is associated with 1-year symptom and health-status improvement. These findings support deformation imaging as a clinically relevant tool for characterizing recovery after M-TEER.
Wong B, Khialani B, Xu J
… +3 more, Ada C, Wu EB, Harding S
Cardiovasc Revasc Med
· 2026 May · PMID 42097945
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Optical coherence tomography (OCT) is a high-resolution intravascular imaging modality that provides detailed assessment of plaque morphology, stent optimization and procedural complications during percutaneous coronary...Optical coherence tomography (OCT) is a high-resolution intravascular imaging modality that provides detailed assessment of plaque morphology, stent optimization and procedural complications during percutaneous coronary intervention (PCI). Conventional OCT requires injection of contrast for blood clearance during image acquisition, which can increase the risk of contrast-induced nephropathy particularly in patients with renal dysfunction. Saline-based OCT has emerged as an alternative strategy to reduce contrast exposure, with available data supporting its safety and diagnostic quality in a substantial proportion of cases. However, its adoption remains limited, largely due to technical challenges in achieving adequate blood clearance with saline. This review article aims to outline the differences in physical properties between saline and contrast, highlights practical technical considerations for saline-based OCT acquisition, and proposes strategies for workflow integration in contemporary PCI practice.
Munshi R, Ghay S, Daher R
… +13 more, Sanku K, Mihos CG, Shatanof R, Raafat MH, Kassar A, Donatelle M, Ujueta F, Wessly P, Welty FK, Alfaddagh A, Elajami TK, Abbas AE, Palomo A
INTRODUCTION: Transcatheter aortic valve replacement (TAVR) is an established treatment for severe aortic stenosis. Although TAVR has improved clinical outcomes, data on racial and ethnic differences in in-hospital clini...INTRODUCTION: Transcatheter aortic valve replacement (TAVR) is an established treatment for severe aortic stenosis. Although TAVR has improved clinical outcomes, data on racial and ethnic differences in in-hospital clinical outcomes and their temporal trends, particularly within urban hospital settings, remain limited. Accordingly, we examined racial and ethnic differences in in-hospital outcomes and their temporal trends among patients undergoing TAVR in urban hospitals. METHODS: We utilized the National Inpatient Sample from 2016 through 2022 and identified TAVR-related hospitalizations in urban hospitals. Patients were classified by race and ethnicity, with White patients serving as the reference group. Primary endpoints included in-hospital mortality and major adverse cardiovascular events. Secondary endpoints included acute myocardial infarction, stroke, cardiac arrest, acute kidney injury, need for transfusion, mechanical ventilation, and other in-hospital complications. Survey-weighted multivariable analyses were performed. RESULTS: We identified a weighted total of 469,175 hospitalizations for TAVR in urban hospitals. Overall, 87.1% of patients were White, and 12.9% were racial and ethnic minority patients. Compared with White patients, Black and Hispanic patients had higher adjusted odds of major adverse cardiovascular events, driven in part by acute myocardial infarction, while Hispanic patients also had higher in-hospital mortality. Rates of ischemic and hemorrhagic stroke did not differ significantly across groups. Significant race-by-year interactions were observed for in-hospital mortality and blood transfusion. CONCLUSIONS: Our findings highlight persistent racial and ethnic disparities in in-hospital outcomes following TAVR, emphasizing the need for targeted efforts to address inequities in care delivery.