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131 Racial differences in quality of care and long-term outcomes for patients admitted with heart failure

Heart (British Cardiac Society), 2023-06, Vol.109 (Suppl 3), p.A149-A150 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. ;2023 Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. ;ISSN: 1355-6037 ;EISSN: 1468-201X ;DOI: 10.1136/heartjnl-2023-BCS.131

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  • Title:
    131 Racial differences in quality of care and long-term outcomes for patients admitted with heart failure
  • Author: Cannata, Antonio ; Bromage, Daniel ; Hardman, Suzanna ; Cleland, John ; McDonagh, Theresa ; Piper, Susan
  • Subjects: Epidemiology ; Heart Failure ; HFrEF ; Race ; Racial differences
  • Is Part Of: Heart (British Cardiac Society), 2023-06, Vol.109 (Suppl 3), p.A149-A150
  • Description: BackgroundAddressing racial differences in care delivery is one of the current challenges in the diagnosis and treatment of patients with Heart Failure (HF). Compared to Caucasians, patients from minority racial groups with HF and reduced Ejection Fraction (HFrEF) are less likely to receive evidence-based, medical, device or advanced therapies. However, there is a lack of contemporary, nationwide data on racial differences in in-hospital quality of care and long-term outcomes for patients with HFrEF. This analysis aims to investigate racial disparities in the quality of care and long-term outcomes of patients with HFrEF in the UKMethodsWe used linked, routinely collected data from 3 large national UK registries (the National Heart Failure Audit, Hospital Episode Statistics, and the Office for National Statistics) from 2020 to 2022 to investigate care and outcomes for patients with HF. We compared clinical characteristics and long-term events of interest according to self-reported race. A multivariable Cox proportional hazard model was performed adjusting for age, sex, comorbidity profile and clinical characteristics at admission.ResultsA total of 59,727 patients with HFrEF were analysed. At admission, white patients were generally older compared to other ethnicities (79 years [IQR 69;86] for white, 67 years [IQR 56;82] for black, 73 years [IQR 63;82] for Asians, 76 years [IQR 64;85] for mixed race and 73 years [IQR 60;83] for other races, p<0.001). Overall, approximately two-thirds of patients were men (64%, n=38,432), 78% (n=44,425) were admitted in NYHA class III or IV, and approximately half of the patients (49%, n=27,731) presented with moderate to severe peripheral oedema, without clinically meaningful differences between races. In-hospital care was similar between races, as were rates of guideline-recommended medications at discharge (70%, n=36,913 for renin-angiotensin-aldosterone system inhibitors; 84%, n=44,611 for beta-blockers; 52%, n=24,105 for mineralocorticoid receptor antagonists; 88%, n=44611 for diuretics). Over a median follow-up of 71 weeks [IQR 23;146], in an unadjusted analysis, mortality was higher for white patients compared to other races (p<0.001, Figure 1). However, on multivariable analysis, white race was not an independent predictor of adverse outcomes (HR 1.07; 95% CI 0.93 – 1.24; p=0.30).ConclusionFor patients hospitalised with HFrEF in England & Wales, in-hospital quality of care and the percentage of patients discharged on guideline-recommended medications are similar amongst different races. Although post-discharge mortality was higher for white patients, after adjustment, white race was not an independent predictor of adverse events.Abstract 131 Figure 1Race differences in HFrEFConflict of Interestnone
  • Publisher: London: BMJ Publishing Group Ltd and British Cardiovascular Society
  • Language: English
  • Identifier: ISSN: 1355-6037
    EISSN: 1468-201X
    DOI: 10.1136/heartjnl-2023-BCS.131
  • Source: ProQuest Central
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