Abstract 13354: Event-Free Survival in African American Patients with Heart Failure
Introduction: Health outcomes such as event-free survival (cumulative end-point in time to first health event) in heart failure (HF) patients is worse in African American than Caucasians. While the direct impact of traditional risk factors on outcomes are recognized, it is unknown how sociodemographic and psychosocial variables, disease, and treatment factors may alter the relationship between race and event-free survival.
Hypothesis: Sociodemographics (age, gender, economic status), psychosocial factors (anxiety, depression), disease factors (smoking, functional status, diabetes) and treatments (beta blockers, ACE inhibitors) moderate the relationship between race and shorter event-free survival among patients with HF.
Methods: Data were analyzed from 993 outpatients in a multicenter HF registry who were followed for a median of 1.9 years (37% female, 11.3% African American, 64±13 years, 44% NYHA Class III/IV). Data were collected via chart review and interview. Potential proposed moderators were analyzed with race as the predictor and the outcome event-free survival. Regressions were conducted on event-free survival using race and each proposed moderator, and the product of race and each moderator.
Results: A primary analysis showed that African American patients are 1.54 times more likely to experience a cardiac event within this data set (p=.003). Further regression analyses indicate event-free survival in African American patients with HF is not moderated by the proposed moderators (all p>.05). Although an incomplete moderation, interactions with medication and race demonstrated better outcomes in African Americans than Caucasians not on ACE inhibitors, but Caucasians on prescribed ACE inhibitors have better comparative outcomes.
Conclusions: Although many modifiable and non-modifiable risk factors may be associated with event free survival in African American HF patients, sociodemographic, psychosocial, disease, and treatment factors do not moderate the relationship between race and event-free survival. Future research is needed to better understand what factors contribute to and moderate evident disparities in the event-free survival of African American patients with HF.
Author Disclosures: K.L. Adams: None. R.L. Dekker: None. T.A. Lennie: None. M.L. Chung: None. K. Dracup: None. D.K. Moser: None.
- © 2014 by American Heart Association, Inc.