Sex‐ and Race‐Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction
BackgroundSex and race have emerged as important contributors to the phenotypic heterogeneity of heart failure with preserved ejection fraction (HFpEF). However, there remains a need to identify important sex‐ and race‐related differences in characteristics and outcomes using a nationally representa...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2017-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.003330 |
| _version_ | 1811331978294722560 |
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| author | Parag Goyal Tracy Paul Zaid I. Almarzooq Janey C. Peterson Udhay Krishnan Rajesh V. Swaminathan Dmitriy N. Feldman Martin T. Wells Maria G. Karas Irina Sobol Mathew S. Maurer Evelyn M. Horn Luke K. Kim |
| author_facet | Parag Goyal Tracy Paul Zaid I. Almarzooq Janey C. Peterson Udhay Krishnan Rajesh V. Swaminathan Dmitriy N. Feldman Martin T. Wells Maria G. Karas Irina Sobol Mathew S. Maurer Evelyn M. Horn Luke K. Kim |
| author_sort | Parag Goyal |
| collection | DOAJ |
| description | BackgroundSex and race have emerged as important contributors to the phenotypic heterogeneity of heart failure with preserved ejection fraction (HFpEF). However, there remains a need to identify important sex‐ and race‐related differences in characteristics and outcomes using a nationally representative cohort. Methods and ResultsData were obtained from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project—Nationwide Inpatient Sample files between 2008 and 2012. Hospitalizations with a diagnosis of HFpEF were included for analysis. Demographics, hospital characteristics, and age‐adjusted comorbidity prevalence rates were compared between men and women and whites and blacks. In‐hospital mortality was determined and compared for each subgroup. Multivariable regression analyses were used to identify and compare correlates of in‐hospital mortality for each subgroup. A sample of 1 889 608 hospitalizations was analyzed. Men with HFpEF were slightly younger than women with HFpEF and had a higher Elixhauser comorbidity score. Men experienced higher in‐hospital mortality compared with women, a finding that was attenuated after adjusting for comorbidity. Blacks with HFpEF were younger than whites with HFpEF, with lower rates of most comorbidities. Hypertension, diabetes, anemia, and chronic renal failure were more common among blacks. Blacks experienced lower in‐hospital mortality compared with whites, even after adjusting for age and comorbidity. Important correlates of mortality among all 4 subgroups included pulmonary circulation disorders, liver disease, and chronic renal failure. Atrial fibrillation was an important correlate of mortality only among women and blacks. ConclusionsDifferences in patient characteristics and outcomes reinforce the notion that sex and race contribute to the phenotypic heterogeneity of HFpEF. |
| first_indexed | 2024-04-13T16:29:59Z |
| format | Article |
| id | doaj.art-c8fd1a014330402281c921dabb87995b |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T16:29:59Z |
| publishDate | 2017-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-c8fd1a014330402281c921dabb87995b2022-12-22T02:39:37ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-04-016410.1161/JAHA.116.003330Sex‐ and Race‐Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection FractionParag Goyal0Tracy Paul1Zaid I. Almarzooq2Janey C. Peterson3Udhay Krishnan4Rajesh V. Swaminathan5Dmitriy N. Feldman6Martin T. Wells7Maria G. Karas8Irina Sobol9Mathew S. Maurer10Evelyn M. Horn11Luke K. Kim12Division of Cardiology/Department of Medicine, Weill Cornell Medical College, New York, NYDivision of Cardiology/Department of Medicine, Weill Cornell Medical College, New York, NYDepartment of Medicine, Weill Cornell Medical College, New York, NYDivision of Clinical Epidemiology and Evaluative Sciences Research, Weill Cornell Medical College, New York, NYDivision of Cardiology/Department of Medicine, Weill Cornell Medical College, New York, NYDuke Clinical Research Institute, Duke University Medical Center, Durham, NCDivision of Cardiology/Department of Medicine, Weill Cornell Medical College, New York, NYDepartments of Statistical Science and Social Statistics, Cornell University, Ithaca, NYDivision of Cardiology/Department of Medicine, Weill Cornell Medical College, New York, NYDivision of Cardiology/Department of Medicine, Weill Cornell Medical College, New York, NYCenter for Advanced Cardiac Care, Columbia University Medical Center, New York, NYDivision of Cardiology/Department of Medicine, Weill Cornell Medical College, New York, NYDivision of Cardiology/Department of Medicine, Weill Cornell Medical College, New York, NYBackgroundSex and race have emerged as important contributors to the phenotypic heterogeneity of heart failure with preserved ejection fraction (HFpEF). However, there remains a need to identify important sex‐ and race‐related differences in characteristics and outcomes using a nationally representative cohort. Methods and ResultsData were obtained from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project—Nationwide Inpatient Sample files between 2008 and 2012. Hospitalizations with a diagnosis of HFpEF were included for analysis. Demographics, hospital characteristics, and age‐adjusted comorbidity prevalence rates were compared between men and women and whites and blacks. In‐hospital mortality was determined and compared for each subgroup. Multivariable regression analyses were used to identify and compare correlates of in‐hospital mortality for each subgroup. A sample of 1 889 608 hospitalizations was analyzed. Men with HFpEF were slightly younger than women with HFpEF and had a higher Elixhauser comorbidity score. Men experienced higher in‐hospital mortality compared with women, a finding that was attenuated after adjusting for comorbidity. Blacks with HFpEF were younger than whites with HFpEF, with lower rates of most comorbidities. Hypertension, diabetes, anemia, and chronic renal failure were more common among blacks. Blacks experienced lower in‐hospital mortality compared with whites, even after adjusting for age and comorbidity. Important correlates of mortality among all 4 subgroups included pulmonary circulation disorders, liver disease, and chronic renal failure. Atrial fibrillation was an important correlate of mortality only among women and blacks. ConclusionsDifferences in patient characteristics and outcomes reinforce the notion that sex and race contribute to the phenotypic heterogeneity of HFpEF.https://www.ahajournals.org/doi/10.1161/JAHA.116.003330epidemiologyheart failuremortality |
| spellingShingle | Parag Goyal Tracy Paul Zaid I. Almarzooq Janey C. Peterson Udhay Krishnan Rajesh V. Swaminathan Dmitriy N. Feldman Martin T. Wells Maria G. Karas Irina Sobol Mathew S. Maurer Evelyn M. Horn Luke K. Kim Sex‐ and Race‐Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease epidemiology heart failure mortality |
| title | Sex‐ and Race‐Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction |
| title_full | Sex‐ and Race‐Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction |
| title_fullStr | Sex‐ and Race‐Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction |
| title_full_unstemmed | Sex‐ and Race‐Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction |
| title_short | Sex‐ and Race‐Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction |
| title_sort | sex and race related differences in characteristics and outcomes of hospitalizations for heart failure with preserved ejection fraction |
| topic | epidemiology heart failure mortality |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.003330 |
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