Care and outcomes of hispanic patients admitted with heart failure with preserved or reduced ejection fraction findings from get with the guidelines-heart failure

Rey P. Vivo, Selim R. Krim, Nassim R. Krim, Xin Zhao, Adrian F. Hernandez, Eric D. Peterson, Ileana L. Pina, Deepak L. Bhatt, Lee H. Schwamm, Gregg C. Fonarow

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background-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.

Original languageEnglish (US)
Pages (from-to)167-175
Number of pages9
JournalCirculation: Heart Failure
Volume5
Issue number2
DOIs
StatePublished - Mar 2012

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Hispanic Americans
Heart Failure
Guidelines
Quality of Health Care
Odds Ratio
Confidence Intervals
Mortality
Stroke Volume
Inpatients
Multivariate Analysis
Obesity
Hypertension
Survival

Keywords

  • Congestive heart failure
  • Contractile function
  • Health policy and outcome research

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Care and outcomes of hispanic patients admitted with heart failure with preserved or reduced ejection fraction findings from get with the guidelines-heart failure. / Vivo, Rey P.; Krim, Selim R.; Krim, Nassim R.; Zhao, Xin; Hernandez, Adrian F.; Peterson, Eric D.; Pina, Ileana L.; Bhatt, Deepak L.; Schwamm, Lee H.; Fonarow, Gregg C.

In: Circulation: Heart Failure, Vol. 5, No. 2, 03.2012, p. 167-175.

Research output: Contribution to journalArticle

Vivo, Rey P. ; Krim, Selim R. ; Krim, Nassim R. ; Zhao, Xin ; Hernandez, Adrian F. ; Peterson, Eric D. ; Pina, Ileana L. ; Bhatt, Deepak L. ; Schwamm, Lee H. ; Fonarow, Gregg C. / Care and outcomes of hispanic patients admitted with heart failure with preserved or reduced ejection fraction findings from get with the guidelines-heart failure. In: Circulation: Heart Failure. 2012 ; Vol. 5, No. 2. pp. 167-175.
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abstract = "Background-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.",
keywords = "Congestive heart failure, Contractile function, Health policy and outcome research",
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T1 - Care and outcomes of hispanic patients admitted with heart failure with preserved or reduced ejection fraction findings from get with the guidelines-heart failure

AU - Vivo, Rey P.

AU - Krim, Selim R.

AU - Krim, Nassim R.

AU - Zhao, Xin

AU - Hernandez, Adrian F.

AU - Peterson, Eric D.

AU - Pina, Ileana L.

AU - Bhatt, Deepak L.

AU - Schwamm, Lee H.

AU - Fonarow, Gregg C.

PY - 2012/3

Y1 - 2012/3

N2 - Background-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.

AB - Background-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.

KW - Congestive heart failure

KW - Contractile function

KW - Health policy and outcome research

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