Care and Outcomes of Hispanic Patients Admitted With Heart Failure With Preserved or Reduced Ejection Fraction Findings From Get With The Guidelines-Heart Failure

被引:34
|
作者
Vivo, Rey P. [1 ,2 ]
Krim, Selim R. [3 ]
Krim, Nassim R. [4 ]
Zhao, Xin [5 ]
Hernandez, Adrian F. [5 ]
Peterson, Eric D. [5 ]
Pina, Ileana L. [6 ,7 ]
Bhatt, Deepak L. [8 ,9 ]
Schwamm, Lee H. [10 ]
Fonarow, Gregg C. [11 ]
机构
[1] Univ Texas Galveston, Med Branch, Div Cardiol, Galveston, TX 77555 USA
[2] Methodist DeBakey Heart & Vasc Ctr, Houston, TX USA
[3] Ochsner Heart & Vasc Inst, New Orleans, LA USA
[4] Montefiore Med Ctr, Bronx, NY 10467 USA
[5] Duke Clin Res Inst, Durham, NC USA
[6] Albert Einstein Coll Med, Bronx, NY 10467 USA
[7] Montefiore Med Ctr, Bronx, NY 10467 USA
[8] Brigham & Womens Hosp, VA Boston Healthcare Syst, Boston, MA 02115 USA
[9] Harvard Univ, Sch Med, Boston, MA 02115 USA
[10] Massachusetts Gen Hosp, Boston, MA 02114 USA
[11] Univ Calif Los Angeles, Med Ctr, Los Angeles, CA 90024 USA
关键词
congestive heart failure; contractile function; health policy and outcome research; ACUTE MYOCARDIAL-INFARCTION; NATIONAL REGISTRY ADHERE; QUALITY-OF-CARE; SYSTOLIC FUNCTION; INSULIN-RESISTANCE; ETHNIC-DIFFERENCES; RISK-FACTORS; OPTIMIZE-HF; AMERICANS; DISEASE;
D O I
10.1161/CIRCHEARTFAILURE.111.963546
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
ackground-Although individuals of Hispanic ethnicity are at high risk for developing heart failure (HF), little is known about differences between Hispanic HF patients stratified by left ventricular ejection fraction (EF). We compared characteristics, quality of care, and outcomes between Hispanic and non-Hispanic white patients hospitalized for HF with preserved EF (PEF) or reduced EF (REF). Methods and Results-From 247 hospitals in Get With The Guidelines-Heart Failure between 2005-2010, 6117 Hispanics were compared with 71 859 non-Hispanic whites. Forty-six percent of Hispanics had PEF (EF > 40%), whereas 54% had REF (EF <40%); 55% and 45% of non-Hispanic whites had PEF and REF, respectively. Relative to non-Hispanic whites, Hispanics with PEF or REF were more likely to be younger and to have diabetes, hypertension, and overweight/obesity. In multivariate analysis, a lower mortality risk was observed among Hispanics with PEF (odds ratio, 0.50; 95% confidence interval, 0.31-0.81; P=0.005) but not in Hispanics with REF (odds ratio, 0.94; 95% confidence interval, 0.62-1.43; P=0.784) compared with non-Hispanic whites. In all groups, composite performance improved within the study period (Hispanics PEF: 75.2-95.1%; non-Hispanic whites PEF: 79.0-92.7%; Hispanics REF: 67.7-88.4%; non-Hispanic whites REF: 60.8-85.6%, P<0.0001). Conclusions-Hispanic HF patients with PEF had better in-hospital survival than non-Hispanic whites with PEF. Inpatient mortality was similar between groups with REF. Quality of care was similar and improved over time irrespective of ethnicity, highlighting the potential benefit of performance improvement programs in promoting equitable care. (Circ Heart Fail. 2012; 5: 167-175.)
引用
收藏
页码:167 / U118
页数:25
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