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Racial differences in the prevalence and outcomes of atrial fibrillation among patients hospitalized with heart failure.

dc.contributor.author Fonarow, GC
dc.contributor.author Get With the Guidelines Steering Committee and Hospitals
dc.contributor.author Hernandez, Adrian Felipe
dc.contributor.author Liang, L
dc.contributor.author Peterson, Eric David
dc.contributor.author Piccini, Jonathan Paul Sr
dc.contributor.author Thomas, Kevin Lindsey
dc.contributor.author Yancy, Clyde W
dc.coverage.spatial England
dc.date.accessioned 2017-07-06T15:59:27Z
dc.date.available 2017-07-06T15:59:27Z
dc.date.issued 2013-09-26
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/24072530
dc.identifier jah3305
dc.identifier.uri https://hdl.handle.net/10161/15017
dc.description.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.
dc.language eng
dc.relation.ispartof J Am Heart Assoc
dc.relation.isversionof 10.1161/JAHA.113.000200
dc.subject anticoagulation
dc.subject atrial fibrillation
dc.subject heart failure
dc.subject racial disparity
dc.subject risk factors
dc.subject African Americans
dc.subject Aged
dc.subject Aged, 80 and over
dc.subject Anticoagulants
dc.subject Atrial Fibrillation
dc.subject European Continental Ancestry Group
dc.subject Female
dc.subject Heart Failure
dc.subject Hospitalization
dc.subject Humans
dc.subject Male
dc.subject Middle Aged
dc.subject Prevalence
dc.subject Risk Factors
dc.subject Treatment Outcome
dc.subject Warfarin
dc.title Racial differences in the prevalence and outcomes of atrial fibrillation among patients hospitalized with heart failure.
dc.type Journal article
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/24072530
pubs.begin-page e000200
pubs.issue 5
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group School of Medicine
pubs.publication-status Published online
pubs.volume 2
dc.identifier.eissn 2047-9980


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