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4 IMPACT OF RACE AND ETHNICITY IN THE MANAGEMENT AND SURVIVAL OF PATIENTS WITH HEART FAILURE
  1. O. Onugha,
  2. G. Fonarow,
  3. T. Horowich
  1. David Geffen School of Medicine at UCLA, Los Angeles

Abstract

Introduction The role race and ethnicity play in the management and clinical outcomes of heart failure (HF) is complex and not well defined. The goal of this study is to evaluate similarities and differences among ethnic groups in the treatment and outcomes of HF.

Methods In a study of 1,600 patients diagnosed with HF referred to the UCLA Heart Failure Center, we evaluated baseline characteristics, and survival at 1 and 2 years by race/ethnicity. Race/ethnicity data were obtained from the medical records and administrative sources. Patients were divided into 5 subcategories based on race and ethnicity: Asian, Black, White, Hispanic, and Other/Unknown.

Results Patients were mean age 52.62, female 23.8%, and Coronary Artery Disease (CAD) etiology 48.2%. There were significant differences in gender across ethnicities in the diagnosis of HF (p=0.0001), with 40.2% female in Black cohort compared to 16.5% in White cohort. ACEI, beta-blocker, and aldosterone antagonist treatment was similar in race/ethnic groups. However, there was a significant difference (p=0.022) in the prescription of statins between ethnic groups, with over 30% treated in Whites, Hispanics, and Other/Unknown compared to 20% in Asians and Blacks. Unadjusted and adjusted survival was similar among all subgroups.

Conclusion There are significant differences by race/ethnicity in the prevalence of co-morbidities and the management of HF. This is possibly related to differing insurance coverages, physician bias or uncertainty, and genetic heterogeneity. However, these differences did not result in different risk of mortality. Further research in this area is necessary.

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