4.6 Article

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

期刊

CIRCULATION-HEART FAILURE
卷 5, 期 2, 页码 167-U118

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCHEARTFAILURE.111.963546

关键词

congestive heart failure; contractile function; health policy and outcome research

资金

  1. Council of Clinical Cardiology of the AHA
  2. Medtronic
  3. Ortho-McNeil
  4. AHA Pharmaceutical Roundtable
  5. GlaxoSmithKline
  6. Johnson Johnson
  7. Bristol-Meyers Squibb
  8. Sanofi
  9. Merck
  10. Schering-Plough
  11. Lilly
  12. Amarin
  13. Astra Zeneca
  14. Eisai
  15. Ethicon
  16. Sanofi Aventis
  17. National Heart, Lung, and Blood Institute
  18. Medicines Company

向作者/读者索取更多资源

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.)

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