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

Thomas, Kevin L

Piccini, Jonathan P

Liang, Li

Fonarow, Gregg C

Yancy, Clyde W

Peterson, Eric D

Hernandez, Adrian F

Get With the Guidelines Steering Committee and Hospitals

England

2017-07-06T15:59:27Z

2017-07-06T15:59:27Z

2013-09-26

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.

https://www.ncbi.nlm.nih.gov/pubmed/24072530

jah3305

2047-9980

https://hdl.handle.net/10161/15017

eng

Ovid Technologies (Wolters Kluwer Health)

J Am Heart Assoc

10.1161/JAHA.113.000200

anticoagulation

atrial fibrillation

heart failure

racial disparity

risk factors

African Americans

Aged

Aged, 80 and over

Anticoagulants

Atrial Fibrillation

European Continental Ancestry Group

Female

Heart Failure

Hospitalization

Humans

Male

Middle Aged

Prevalence

Risk Factors

Treatment Outcome

Warfarin

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

Journal article

Thomas, Kevin L|0000-0002-0040-5396

Piccini, Jonathan P|0000-0003-0772-2404

Peterson, Eric D|0000-0002-5415-4721

Hernandez, Adrian F|0000-0003-3387-9616

https://www.ncbi.nlm.nih.gov/pubmed/24072530

e000200

5

Clinical Science Departments

Duke

Duke Clinical Research Institute

Institutes and Centers

Medicine

Medicine, Cardiology

School of Medicine

Published online

2