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Racial Differences in the Prevalence and Outcomes of Atrial Fibrillation in Patients Hospitalized With Heart Failure.
Am J Cardiol. 2016 May 01; 117(9):1468-73.AJ

Abstract

Previous research has shown that roughly 15% to 30% of those with heart failure (HF) develop atrial fibrillation (AF). Although studies have shown variations in the incidence of AF in patients with HF, there has been no evidence of mortality differences by race. The purpose of this study was to assess AF prevalence and inhospital mortality in patients with HF among different racial groups in the United States. Using the National Inpatient Sample registry, the largest publicly available all-payer inpatient care database representing >95% of the US inpatient population, we analyzed subjects hospitalized with a primary diagnosis of HF from 2001 to 2011 (n = 11,485,673) using the International Classification of Diseases, Ninth Edition (ICD 9) codes 428.0-0.1, 428.20-0.23, 428.30-0.33, 428.40-0.43, and 428.9; patients with AF were identified using the ICD 9 code 427.31. We assessed prevalence and mortality among racial groups. Using logistic regression, we examined odds of mortality adjusted for demographics and co-morbidity using Elixhauser co-morbidity index. We also examined utilization of procedures by race. Of the 11,485,673 patients hospitalized with HF in our study, 3,939,129 (34%) had AF. Patients with HF and AF had greater inhospital mortality compared with those without AF (4.6% vs 3.3% respectively, p <0.0001). Additionally, black, Hispanic, Asian, and white patients with HF and AF had a 24%, 17%, 13%, and 6% higher mortality, respectively, than if they did not have AF. Among patients with HF and AF, minority racial groups had underutilization of catheter ablation and cardioversion compared with white patients. In conclusion, minority patients with HF and AF had a disproportionately higher risk of inpatient death compared with white patients with HF. We also found a significant underutilization of cardioversion and catheter ablation in minority racial groups compared with white patients.

Authors+Show Affiliations

School of Medicine, University of California, Irvine, California.Division of Cardiology, Department of Medicine, University of California, Irvine, California.Division of Cardiology, Department of Medicine, University of California, Irvine, California.Division of Cardiology, Department of Medicine, University of California, Irvine, California.Division of Cardiology, Department of Medicine, University of California, Irvine, California.Division of Cardiology, Department of Medicine, University of California, Irvine, California.Division of Cardiology, Department of Medicine, University of California, Irvine, California. Electronic address: smalik@uci.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26970814

Citation

Bhatia, Subir, et al. "Racial Differences in the Prevalence and Outcomes of Atrial Fibrillation in Patients Hospitalized With Heart Failure." The American Journal of Cardiology, vol. 117, no. 9, 2016, pp. 1468-73.
Bhatia S, Qazi M, Erande A, et al. Racial Differences in the Prevalence and Outcomes of Atrial Fibrillation in Patients Hospitalized With Heart Failure. Am J Cardiol. 2016;117(9):1468-73.
Bhatia, S., Qazi, M., Erande, A., Shah, K., Amin, A., Patel, P., & Malik, S. (2016). Racial Differences in the Prevalence and Outcomes of Atrial Fibrillation in Patients Hospitalized With Heart Failure. The American Journal of Cardiology, 117(9), 1468-73. https://doi.org/10.1016/j.amjcard.2016.02.016
Bhatia S, et al. Racial Differences in the Prevalence and Outcomes of Atrial Fibrillation in Patients Hospitalized With Heart Failure. Am J Cardiol. 2016 May 1;117(9):1468-73. PubMed PMID: 26970814.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial Differences in the Prevalence and Outcomes of Atrial Fibrillation in Patients Hospitalized With Heart Failure. AU - Bhatia,Subir, AU - Qazi,Mohammad, AU - Erande,Ashwini, AU - Shah,Kunjan, AU - Amin,Alpesh, AU - Patel,Pranav, AU - Malik,Shaista, Y1 - 2016/02/17/ PY - 2015/09/18/received PY - 2016/02/08/revised PY - 2016/02/08/accepted PY - 2016/3/14/entrez PY - 2016/3/14/pubmed PY - 2016/8/23/medline SP - 1468 EP - 73 JF - The American journal of cardiology JO - Am J Cardiol VL - 117 IS - 9 N2 - Previous research has shown that roughly 15% to 30% of those with heart failure (HF) develop atrial fibrillation (AF). Although studies have shown variations in the incidence of AF in patients with HF, there has been no evidence of mortality differences by race. The purpose of this study was to assess AF prevalence and inhospital mortality in patients with HF among different racial groups in the United States. Using the National Inpatient Sample registry, the largest publicly available all-payer inpatient care database representing >95% of the US inpatient population, we analyzed subjects hospitalized with a primary diagnosis of HF from 2001 to 2011 (n = 11,485,673) using the International Classification of Diseases, Ninth Edition (ICD 9) codes 428.0-0.1, 428.20-0.23, 428.30-0.33, 428.40-0.43, and 428.9; patients with AF were identified using the ICD 9 code 427.31. We assessed prevalence and mortality among racial groups. Using logistic regression, we examined odds of mortality adjusted for demographics and co-morbidity using Elixhauser co-morbidity index. We also examined utilization of procedures by race. Of the 11,485,673 patients hospitalized with HF in our study, 3,939,129 (34%) had AF. Patients with HF and AF had greater inhospital mortality compared with those without AF (4.6% vs 3.3% respectively, p <0.0001). Additionally, black, Hispanic, Asian, and white patients with HF and AF had a 24%, 17%, 13%, and 6% higher mortality, respectively, than if they did not have AF. Among patients with HF and AF, minority racial groups had underutilization of catheter ablation and cardioversion compared with white patients. In conclusion, minority patients with HF and AF had a disproportionately higher risk of inpatient death compared with white patients with HF. We also found a significant underutilization of cardioversion and catheter ablation in minority racial groups compared with white patients. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/26970814/Racial_Differences_in_the_Prevalence_and_Outcomes_of_Atrial_Fibrillation_in_Patients_Hospitalized_With_Heart_Failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(16)30229-6 DB - PRIME DP - Unbound Medicine ER -