Care and Outcomes of Hispanic Patients Admitted with Heart Failure with Preserved or Reduced Ejection Fraction: Findings from Get With The Guidelines-Heart Failure
Background—While 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 through 2010, 6,117 Hispanics were compared with 71,859 non-Hispanic whites. 46% of Hispanics had PEF (EF >40%) while 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 (OR, 0.55; 95% CI, 0.37 to 0.81; P = 0.003), but not in Hispanics with REF (OR, 0.92; 95% CI, 0.66 to 1.28; P = 0.628), compared with non-Hispanic whites. In all groups, composite performance improved within the study period (Hispanics PEF 75.2% to 95.1%; non-Hispanic whites PEF 79.0% to 92.7%; Hispanics REF 67.7% to 88.4%; non-Hispanic whites REF 79.0% to 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.
- Received July 18, 2011.
- Accepted January 5, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited