دورية أكاديمية
Disparities in Practice Patterns by Sex, Race, and Ethnicity in Patients Referred for Advanced Heart Failure Therapies.
| العنوان: | Disparities in Practice Patterns by Sex, Race, and Ethnicity in Patients Referred for Advanced Heart Failure Therapies. |
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| المؤلفون: | Herr JJ; Sutter Health CPMC Center for Advanced Heart Failure Therapies, California Pacific Medical Center, San Francisco, California. Electronic address: Jared.Herr@sutterhealth.org., Sheikh FH; MedStar Heart and Vascular Institute, Advanced Heart Failure Program, Georgetown University, Washington, District of Columbia., Patel PJ; St. Vincent Heart Center of Indiana, Indianapolis, Indiana., Lala A; Department of Population Health Science and Policy, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York., Chien CV; Division of Cardiology, University of North Carolina, Chapel Hill, North Carolina., Hsiao S; Sutter Health CPMC Center for Advanced Heart Failure Therapies, California Pacific Medical Center, San Francisco, California., Srivastava A; Section of Advanced Heart Failure, Department of Cardiology, Scripps Clinic., Pedrotty D; Cardiovascular Division, University of Minnesota School of Medicine, Minneapolis, Minnesota., Nowaczyk J; Section of Advanced Heart Failure, Department of Cardiology, Scripps Clinic., Tompkins S; MedStar Heart and Vascular Institute, Advanced Heart Failure Program, Georgetown University, Washington, District of Columbia., Ahmed S; St. Vincent Heart Center of Indiana, Indianapolis, Indiana., Xiang F; Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio; Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, China., Forest S; Department of Cardiothoracic Surgery, Montefiore Medical Center, Bronx, New York., Tong MZ; Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio., Kamdar F; Cardiovascular Division, University of Minnesota School of Medicine, Minneapolis, Minnesota., D'Souza B; Department of Cardiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania., Ravichandran A; St. Vincent Heart Center of Indiana, Indianapolis, Indiana. |
| مؤلفون مشاركون: | IDEAL-HF Investigators |
| المصدر: | The American journal of cardiology [Am J Cardiol] 2022 Dec 15; Vol. 185, pp. 46-52. Date of Electronic Publication: 2022 Oct 22. |
| نوع المنشور: | Multicenter Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0207277 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1913 (Electronic) Linking ISSN: 00029149 NLM ISO Abbreviation: Am J Cardiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Excerpta Medica |
| مواضيع طبية MeSH: | Heart-Assist Devices*/adverse effects , Heart Failure*/epidemiology , Heart Failure*/therapy , Heart Transplantation*, Humans ; Male ; United States/epidemiology ; Middle Aged ; Female ; Retrospective Studies ; Ethnicity ; Referral and Consultation |
| مستخلص: | Advanced heart failure (HF) therapies improve survival in patients with stage D HF. We sought to evaluate differences by race/ethnicity and sex in advanced HF therapy referrals and decision-making across a multicenter survey. We performed a retrospective analysis of patients referred for evaluation for advanced HF therapies at 9 centers (n = 515) across the United States. The median age was 58 years, and 73% were male. White patients comprised 55.7% of referrals, whereas non-White patients comprised 44.3%. Non-ischemic etiology was more common in non-White patients (66.6% vs 47.4% p = 0.0005), and ischemic etiology was more common in men (37.8% vs 20.4% p = 0.0005). The primary reason for referral differed by race/ethnicity but not sex, with ventricular arrhythmias (7.6% vs 3%, p = 0.024) and pulmonary hypertension (3.4% vs 0.4% p = 0.018) being more common in White patients, whereas worsening HF was less common (25.4% vs 35.9%; p = 0.009). White patients were offered left ventricular assist devices (LVADs) (60.3% vs 54.7 p = 0.039) and heart transplants (51.8% vs 33.1% p = 0.0007) more often than non-White patients. The preference not to pursue LVAD therapy was more common in non-White patients (17.6% vs 9.6%; p = 0.049). Men were more often declined for a heart transplant because of psychosocial contraindications (34% vs 15%, p = 0.005). In conclusion, in this multicenter analysis of referrals for advanced HF therapies, we observed significant differences by race, ethnicity, and sex in both referral characteristics and evaluation outcomes. Further investigation is warranted to better understand why rates of LVAD and transplantation may be lower in non-White patients who are referred for advanced therapies. (Copyright © 2022 Elsevier Inc. All rights reserved.) |
| تواريخ الأحداث: | Date Created: 20221024 Date Completed: 20221114 Latest Revision: 20221123 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.amjcard.2022.09.015 |
| PMID: | 36280472 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1879-1913 |
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| DOI: | 10.1016/j.amjcard.2022.09.015 |