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Racial differences in the prevalence and outcomes of atrial fibrillation among patients hospitalized with heart failure.
J Am Heart Assoc. 2013 Sep 26; 2(5):e000200.JA

Abstract

BACKGROUND

The intersection of heart failure (HF) and atrial fibrillation (AF) is common, but the burden of AF among black patients with HF is poorly characterized. We sought to determine the prevalence of AF, characteristics, in-hospital outcomes, and warfarin use associated with AF in patients hospitalized with HF as a function of race.

METHODS AND RESULTS

We analyzed data on 135 494 hospitalizations from January 2006 through January 2012 at 276 hospitals participating in the American Heart Association's Get With The Guidelines HF Program. Multivariable logistic regression models using generalized estimating equations approach for risk-adjusted comparison of AF prevalence, in-hospital outcomes, and warfarin use. In this HF population, 53 389 (39.4%) had AF. Black patients had markedly less AF than white patients (20.8% versus 44.8%, P < 0.001). Adjusting for risk factors and hospital characteristics, black race was associated with significantly lower odds of AF (adjusted odds ratio 0.52, 95% CI 0.48 to 0.55, P < 0.0001). There were no racial differences in in-hospital mortality; however, black patients had a longer length of stay relative to white patients. Black patients compared with white patients with AF were less likely to be discharged on warfarin (adjusted odds ratio 0.76, 95% CI 0.69 to 0.85, P < 0.001).

CONCLUSIONS

Despite having many risk factors for AF, black patients, relative to white patients hospitalized for HF, had a lower prevalence of AF and lower prescription of guideline-recommended warfarin therapy.

Authors+Show Affiliations

Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24072530

Citation

Thomas, Kevin L., et al. "Racial Differences in the Prevalence and Outcomes of Atrial Fibrillation Among Patients Hospitalized With Heart Failure." Journal of the American Heart Association, vol. 2, no. 5, 2013, pp. e000200.
Thomas KL, Piccini JP, Liang L, et al. Racial differences in the prevalence and outcomes of atrial fibrillation among patients hospitalized with heart failure. J Am Heart Assoc. 2013;2(5):e000200.
Thomas, K. L., Piccini, J. P., Liang, L., Fonarow, G. C., Yancy, C. W., Peterson, E. D., & Hernandez, A. F. (2013). Racial differences in the prevalence and outcomes of atrial fibrillation among patients hospitalized with heart failure. Journal of the American Heart Association, 2(5), e000200. https://doi.org/10.1161/JAHA.113.000200
Thomas KL, et al. Racial Differences in the Prevalence and Outcomes of Atrial Fibrillation Among Patients Hospitalized With Heart Failure. J Am Heart Assoc. 2013 Sep 26;2(5):e000200. PubMed PMID: 24072530.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial differences in the prevalence and outcomes of atrial fibrillation among patients hospitalized with heart failure. AU - Thomas,Kevin L, AU - Piccini,Jonathan P, AU - Liang,Li, AU - Fonarow,Gregg C, AU - Yancy,Clyde W, AU - Peterson,Eric D, AU - Hernandez,Adrian F, AU - ,, Y1 - 2013/09/26/ PY - 2013/9/28/entrez PY - 2013/9/28/pubmed PY - 2014/1/7/medline KW - anticoagulation KW - atrial fibrillation KW - heart failure KW - racial disparity KW - risk factors SP - e000200 EP - e000200 JF - Journal of the American Heart Association JO - J Am Heart Assoc VL - 2 IS - 5 N2 - BACKGROUND: The intersection of heart failure (HF) and atrial fibrillation (AF) is common, but the burden of AF among black patients with HF is poorly characterized. We sought to determine the prevalence of AF, characteristics, in-hospital outcomes, and warfarin use associated with AF in patients hospitalized with HF as a function of race. METHODS AND RESULTS: We analyzed data on 135 494 hospitalizations from January 2006 through January 2012 at 276 hospitals participating in the American Heart Association's Get With The Guidelines HF Program. Multivariable logistic regression models using generalized estimating equations approach for risk-adjusted comparison of AF prevalence, in-hospital outcomes, and warfarin use. In this HF population, 53 389 (39.4%) had AF. Black patients had markedly less AF than white patients (20.8% versus 44.8%, P < 0.001). Adjusting for risk factors and hospital characteristics, black race was associated with significantly lower odds of AF (adjusted odds ratio 0.52, 95% CI 0.48 to 0.55, P < 0.0001). There were no racial differences in in-hospital mortality; however, black patients had a longer length of stay relative to white patients. Black patients compared with white patients with AF were less likely to be discharged on warfarin (adjusted odds ratio 0.76, 95% CI 0.69 to 0.85, P < 0.001). CONCLUSIONS: Despite having many risk factors for AF, black patients, relative to white patients hospitalized for HF, had a lower prevalence of AF and lower prescription of guideline-recommended warfarin therapy. SN - 2047-9980 UR - https://www.unboundmedicine.com/medline/citation/24072530/Racial_differences_in_the_prevalence_and_outcomes_of_atrial_fibrillation_among_patients_hospitalized_with_heart_failure_ L2 - https://www.ahajournals.org/doi/10.1161/JAHA.113.000200?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -