Socioeconomic Disparities in Patients Undergoing Alcohol Septal Ablation for Hypertrophic Cardiomyopathy.

Background: Alcohol septal ablation (ASA) effectively treats select patients with hypertrophic obstructive cardiomyopathy (HOCM). Our study analyzes socioeconomic and geographic factors' influence on post-ASA outcomes to improve patient care and accessibility. Methods: Using the National Inpatient Sample (2016-2021) and International Classification of Diseases 10th Revision codes, we identified patients with a primary diagnosis of HOCM who underwent ASA. Study populations were categorized into 3 groups based on the poverty income ratio. The primary outcome was in-hospital complications following the procedure. Secondary outcomes included length of stay, hospitalization costs, and disposition status. Results: Of 8585 patients who underwent ASA, 45.3% were from low SES backgrounds. Medicare was the primary payer, with treatments predominantly occurring in urban teaching hospitals for elective procedures in the southern region. Low and middle-SES patients showed higher rates of in-hospital mortality, sudden cardiac arrest, and increased pacemaker placements compared to high-SES groups. They experienced more extended hospital stays, which was associated with higher hospitalization costs and more transfers to skilled nursing facilities than high SES patients (all Conclusions: Lower and middle socioeconomic HOCM patients who underwent ASA face higher in-hospital mortality, more sudden cardiac arrests, increased pacemaker placements, and more extended hospital stays compared to higher socioeconomic patients, highlighting the need for standardized outcomes for all ASA patients.