Abstract 11420: Racial Differences in Heart Failure Presentation and Outcome: A Get-With-The-Guidelines Heart Failure Study
Background: Millions of Americans are living with heart failure (HF), and minorities represent a large proportion of these patients. Racial differences in outcomes of patients with HF have been previously described. Examining racial differences in presentation and factors precipitating admission with HF in minorities may help to reduce gaps in care and improve outcomes.
Methods: We examined 3763 all-cause admissions for HF at our center (2005-2012) using the GWTG-HF study. Minorities represented 33% of the overall cohort (1216 blacks and 39 other races). Baseline characteristics and outcomes were compared between minorities and Caucasians using independent T Test, Pearson Chi Square and Fisher Exact Test during index admissions.
Results: Racial differences in baseline characteristics and comorbidities were identified. (Table) Compared to Caucasians, minorities were younger, had a higher BMI, and were more likely to have nonischemic cardiomyopathy, HTN, diabetes, and renal insufficiency. Minorities were also more likely to be uninsured and were less likely to have CAD, prior MI and atrial fibrillation. Minorities had a 1.3 times greater odds than Caucasians to be readmitted (95% CI 1.1 -1.5). When examining factors contributing to HF admission, minorities were more likely to have medical (34% vs. 17%) or dietary (63% vs. 51%) noncompliance, worsening renal failure (28% vs. 21%), or worsening hypertension (46% vs. 28%) than Caucasians. (p <0.001 for all).
Conclusion: Minorities with HF demonstrated significant differences in comorbidities, insurance status, and triggers for HF exacerbations than Caucasians, leading to a greater risk for re-hospitalization. A focus on racial differences in factors precipitating HF exacerbations or potential differences related to access to care that vary by race may provide a more targeted approach to improving outcomes and reducing readmissions, helping to reduce racial gaps.
Author Disclosures: E. Eno: None. K. Nathan: None. A. Mithani: None. M. Daneshvar: None. M. Ortman: None. J. Andriulli: Consultant/Advisory Board; Modest; Medtronic, Spectranetics. A.M. Russo: Research Grant; Modest; Boehringer Ingelheim. Research Grant; Significant; Boston Scientific, Medtronic. Honoraria; Modest; Biotronik, Medtronic, Boston Scientific, St. Jude. Consultant/Advisory Board; Modest; Boston Scientific. Other; Modest; Fellowship Support- Boston Scientific, Fellowship Support- Medtronic.
- © 2016 by American Heart Association, Inc.