Abstract 19498: Race-Specific Impact of Atrial Fibrillation Risk Factors in Blacks, Hispanics, and Whites in an Electronic Medical Record
Introduction: Cohort studies have shown that despite a greater burden of traditional risk factors, atrial fibrillation (AF) is less common among non-whites than whites for unclear reasons. However, the role of race-specific influences of medical factors and outcomes related to AF in African Americans (AA), Hispanic-Latino (HL), Asian (AS), or Caucasian (C) has not been examined in an electronic medical record (EMR).
Hypothesis: To test the hypothesis that race-specific risk factors play an important role in the etiology and outcome of patients with AF using an EMR.
Methods: Using the UIC EMR, 3607 patients with an ICD-9 CM 427.3 for AF were identified over a 7 year period (2008-2015). Multivariate analysis of variance was used to compare incidence of AF risk factors with subgroup analysis. Risk factors were identified from ICD-9 CM: hypertension (HTN), diabetes mellitus (DM), stroke/TIA, smoking, COPD, vascular disease, obstructive sleep apnea (OSA). Manual review of EMR was performed in 171 of the 3607 patients to validate both AF diagnosis and CHA2DS2-VASC score (CVS).
Results: Total hospitalizations: 39.6% (AA); 29.9% (C); 10.7% (HL); 2.4% (AS); and 17.4% (Other). AA and HL were more likely to have HTN as compared with C and AS (85% & 84% vs. 76% & 74%; P<0.001), and vascular disease (48.3% & 54% vs. 37.3% & 39.5%; P<0.01). AA were more likely to be smokers vs. HL or C (39% vs 28% & 28%; P<0.01). C had a lower rate of stroke/TIA than AA or HL (19% vs. 27% & 24%; P<0.01) giving rise to a lower CVS (3.17 vs 3.62 and 3.80; P<0.01). Of the 171 EMRs manually reviewed, 2 did not have AF (false positive rate 1.2%). EMR-validated CVS was 3.3, while the algorithm-calculated CVS was 3.4 (P>0.05).
Conclusion: Patterns of AF risk factors varied between ethnicities. Non-whites hospitalized with AF were more likely to have HTN, vascular disease, stroke, and smoking history than whites. Our findings support the role of the EMR in delineating the role of ethnic-specific risk factors in the etiology of AF.
Author Disclosures: T.L. Shih: None. B. Romer: None. M. Al-Yafi: None. B. Rao: None. B. Chalazan: None. M. McCauley: None. H. Huang: None. W. Galanter: None. D. Darbar: None.
- © 2016 by American Heart Association, Inc.