Abstract 16863: Racial Differences in Atrial Fibrillation Prevalence and Anticoagulation Use
Background: Atrial fibrillation (AF) is common in heart failure (HF). Studies have suggested blacks are less likely to develop AF relative to whites, but less is known regarding racial differences in AF in patients with HF. In patients hospitalized with HF, we assessed the prevalence, characteristics, anticoagulation use at discharge, and inpatient mortality associated with AF as a function of race.
Methods: We analyzed 135,494 hospitalizations from January 2006 through January 2012 at 276 hospitals participating in the American Heart Association’s Get With The Guidelines HF Program. Pearson Chi square and Wilcoxon Rank-sum tests were used for comparing the prevalence, oral anticoagulation use, and inpatient mortality by race and generalized estimating equations multivariable logistic regression models for AF, anticoagulation use in eligible patients, and inpatient mortality.
Results: In this HF population, 53,389 (39.4%) had AF. Blacks (n=30,290) had markedly less AF compared with whites (20.8% vs 44.8%, p<0.001). Among those with AF, blacks were younger, less insured, and more likely to have diabetes, hypertension, history of CVA’s, renal insufficiency, ESRD, and reduced EF. After adjusting for known risk factors, black race was associated with a significantly lower odds of AF (adjusted odds ratio 0.52, 95% confidence intervals 0.48-0.55, p <0.0001). Among eligible individuals, 69.1% of whites and 65.0% of blacks received oral anticoagulation for AF. Blacks with AF were less likely to be discharged on oral anticoagulation (adjusted OR 0.76, 95% CI 0.69-0.85, p<0.0001). Black race was associated with a non-significant trend toward lower inpatient mortality (adjusted OR 0.79, 95% CI 0.61-1.02, p=0.08).
Conclusions: Despite having more risk factors for AF, blacks hospitalized for HF, had a lower prevalence of AF and lower prescription of guideline recommended anticoagulation.
- © 2012 by American Heart Association, Inc.