Abstract 376: African-American Patients Presenting with Unexplained Syncope Have Significantly Worse Outcome Compared to Other Races: An ACAP-SELF Dataset Analysis

Abstract

Background: In the US, 2 million people are evaluated for syncope annually. Published literature shows that of all ethnicities, African Americans (AA) are more likely to have comorbidities like hypertension, diabetes & lifestyle risk factors that translate to poorer outcome. Having published short-term outcomes showing worse outcome for AA with syncope, we followed up these patients over 5 years to evaluate long-term outcomes. Methods: 3044 patients were prospectively followed after presenting with syncope. Patients were separated into five ethnic groups: Caucasians(30%), AA(30%), Hispanics(20%), Asians(3%) and others(17%). Patients or relatives were interviewed at least yearly during the follow-up period of 5 years. The primary endpoint was a composite of readmission for syncope, myocardial infarction, stroke or death. Results: AA were older with mean age of 68±20 years, had hypertension (72% vs. 60%, p<0.001), higher creatinine levels (1.5mg/dl vs. 1.2mg/dl, p< 0.001), diabetes (28% vs. 23%, p<0.001), heart failure (12% vs. 9%, p=0.04), and smoking (26% vs. 10%; p=0.003). Compared to all other races, AA had significantly worse outcome as seen by the KM curve in the primary endpoint (33% vs. 25%; HR 1.5; 95% CI: 1.25-1.75; p<0.0001). Conclusions: AA who are admitted with unexplained syncope are identified according to the SELF pathway as high risk group that can likely be attributed to the presence of comorbidities and warrants hospitalization for further work-up and optimizing medical management.