Abstract 11305: Left Ventricular Dysfunction is a Stronger Predictor of Congestive Heart Failure Events Amongst Hispanic Compared to Non-Hispanic Patients
Introduction: The Hispanic population is the fastest growing and largest minority group in the United States. Although NIH-funded epidemiological studies are currently evaluating risk factors for cardiovascular events in this group, few preliminary data are currently available. We examined how transthoracic echocardiographic (TTE) parameters of left ventricular function predict congestive heart failure (CHF) events in an urban setting enriched with a large Hispanic population.
Methods: The first available TTE was reviewed for 18,522 consecutive patients imaged at our institution’s inpatient and outpatient sites in 2010. Demographic and clinical data were gathered via our center’s electronic patient information database. CHF admissions at our institution and patient deaths using the social security index prior to December 2011 were queried. Socioeconomic status (SES) was inferred from the mean household income based on zip code.
Results: The population was diverse (39% Hispanic, 19% non-Hispanic white, and 34% non-Hispanic black). The association of systolic dysfunction (EF<50%) and diastolic dysfunction (E/E’>15) with CHF events (admission or death) was examined using a multivariate Cox regression that adjusted for age, sex, ethnicity, race, BMI, SES, indication for TTE, clinical setting (outpatient, inpatient, ED, ICU), medications (statins, beta-blocker, ACE-I/ARB, diuretics), and comorbidities (Cr>1.5mg/dL, AST>150U/L, Tbili>2mg/dL, Alb<3g/dL, LDL>160mg/dL). The association of systolic dysfunction and CHF events was stronger amongst Hispanics (HR 1.93; 95%CI 1.68 [[Unable to Display Character: –]] 2.22, p<0.001) than non-Hispanics (HR 1.70; 95%CI 1.53 [[Unable to Display Character: –]] 1.88, p<0.001). This interaction was statistically significant, p=0.036. No interaction was seen amongst racial groups. Diastolic dysfunction also predicted CHF events (HR 1.43; 95%CI 1.33 [[Unable to Display Character: –]] 1.55, p<0.001), but no interaction was seen with ethnicity or race.
Conclusions: Among patients referred for TTE for a wide variety of indications, systolic dysfunction was a stronger predictor of CHF events amongst Hispanic patients compared to non-Hispanic patients. The prediction of CHF events with diastolic dysfunction was similar between groups.
- © 2013 by American Heart Association, Inc.