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Racial disparities among Asian Americans with atrial fibrillation: An analysis from the NCDR® PINNACLE Registry.

Abstract：

BACKGROUND:There is paucity of data on Atrial Fibrillation (AF) management and associated clinical outcomes among Asian Americans. This study sought to investigate baseline risk factor profiles, racial disparities in clinical management and adverse clinical outcomes among White and Asian Americans. METHODS:We used National Cardiovascular Data Registry (NCDR®) Practice Innovation and Clinical Excellence (PINNACLE) registry and linked Centers of Medicare and Medicaid Services data to identify Asian and White patients with AF between January 1, 2013-June 30, 2018. We compared rates of baseline risk factors, management strategies (rate versus rhythm control), anticoagulation use and rates of adverse events between racial groups. The two race groups were compared using hierarchical multivariable adjusted regression models to account for site and confounders. RESULTS:In total, 1,359,827 patients (18,793 Asians and 1,341,034 Whites) were included in our analysis. Compared to White Americans, Asian Americans were more likely to use a rate control strategy (Odds Ratio [OR]: 1.20, 95% Confidence Interval [CI]: 1.15-1.25) and lower odds of rhythm control strategy (atrial ablations, cardioversions, or use of antiarrhythmic drugs) (OR: 0.83, 95% CI: 0.80-0.87) in adjusted analysis. Use of oral anticoagulants and direct oral anticoagulants were similar. There were no significant race-based differences in likelihood of all-cause mortality, stroke, and bleeding requiring hospitalization. Analyses performed using propensity score matching were consistent with the main results. CONCLUSIONS:Asian Americans with AF have a lower likelihood of being managed with rhythm control strategies. Overall use of OAC and AF related adverse events remain similar between the two racial groups.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Gu K,Mahtta D,Kaneria A,Sharedalal P,Dennis B,Song Y,Wei X,Khalid U,Hess P,Cho SH,Virani SS

doi

10.1016/j.ijcard.2020.12.064

subject

Has Abstract

pub_date

2021-01-05 00:00:00

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(20)34312-6

pub_type

杂志文章

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Racial disparities among Asian Americans with atrial fibrillation: An analysis from the NCDR® PINNACLE Registry.