Abstract 19166: Major Gap Exists Between Races in Applying Published Guidelines for Primary Prevention of Sudden Cardiac Death; An ESCAPE Database Analysis
Background: We have developed a novel ESCAPE pathway and registry to monitor, evaluate and guide physician’s referral for patients who meet class I indication of ICD implantation.
Methods: All heart failure (HF) patients admitted to an inner city hospital and presented to our imaging laboratories with LVEF ≤35% and met Class I criteria for an Implantable ICD were prospectively followed and included in this study. Number of implanted devices and patient outcome of death and HF readmissions were assessed at 24-month and compared between the races.
Results: A total of 1087 enrolled in this registry including 472 (43%) African Americans (AA) and 205 (19%) Hispanics (H). AA patients had a mean age of 64 ± 15 years, 75% with hypertension, 33% diabetics, and 30% with coronary artery disease. At the end of the follow-up period, only 88 (22%) AA and 42 (25%) H patients underwent ICD implantation; yet 183 (38%) AA patients and 61 (29%) H Patients had adverse outcomes. These included 99 (20%) deaths and 109 (23%) HF readmissions for AA, patients and 31 (16%) deaths and 35 (17%) HF readmissions for H patients (Figure).
Conclusions: This real world prospective study reveals the significant gap and underutilization of ICD among special race eligible patients who carry a worse outcome.
- © 2012 by American Heart Association, Inc.