Most Important Articles on Cardiovascular Disease Among Racial and Ethnic Minorities

Mody, Purav; Gupta, Aakriti; Bikdeli, Behnood; Lampropulos, Julianna F.; Dharmarajan, Kumar

doi:10.1161/circoutcomes.112.967638

Cited by 38 publications

(35 citation statements)

References 55 publications

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“…Moreover, because women and racial and ethnic minorities are underrepresented in published studies, the predictive value of D‐PA–based risk models for these patient groups is unknown. This is concerning, because traditional cardiovascular risk assessment tools have been shown to underestimate risk in women and minority patients …”

Section: Resultsmentioning

confidence: 99%

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Measuring Physical Activity With Implanted Cardiac Devices: A Systematic Review

Rosman

Lampert

Sears

et al. 2018

JAHA

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BackgroundPhysical activity is predictive of cardiovascular outcomes in patients with cardiovascular implantable electronic devices, yet it is not regularly assessed in routine care. Current‐generation cardiovascular implantable electronic devices, however, continuously monitor patient activity through a built‐in accelerometer, which provides new opportunities to remotely assess patient activity, detect changes in clinical status, and incorporate these data in risk stratification models. This review critically examines the literature on device‐measured physical activity (D‐PA), with a focus on identifying methodological issues that may affect interpretation of study results.Methods and ResultsWe conducted a systematic review of D‐PA studies published from January 1 1995 to December 30 2017, identifying 29 studies meeting inclusion criteria, 5 of which were validation reports. Few technical details about D‐PA sensors are reported, and procedures for analyzing and interpreting D‐PA data are heterogeneous. Trends in D‐PA over time and associations with clinical outcomes were reported by 22 studies, and in 7 studies, D‐PA was combined with other device parameters in risk stratification models, demonstrating modest‐to‐good sensitivity in predicting acute heart failure decompensation, hospitalization, and mortality.ConclusionsCurrent evidence suggests that D‐PA may be useful for assessing physical activity and predicting clinical outcomes in patients with cardiovascular implantable electronic devices when combined with other device parameters. Future work must address challenges related to D‐PA data measurement, interpretation, and generalizability to support expanded clinical applications of this technology.

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Section: Resultsmentioning

confidence: 99%

“…This is concerning, because traditional cardiovascular risk assessment tools have been shown to underestimate risk in women and minority patients. 39,40…”

Section: D-pa In Risk Stratification Modelsmentioning

confidence: 99%

Measuring Physical Activity With Implanted Cardiac Devices: A Systematic Review

Rosman

Lampert

Sears

et al. 2018

JAHA

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“…Additionally, entrenched institutional racism leads to inequities in access to and quality of health care. Studies have demonstrated pervasive disparities between treatment of blacks and whites in health care delivery in realms such as clinician adherence to prescribing guidelines, therapy intensification, and use of invasive cardiac procedures, even after controlling for clinical and socioeconomic factors [1].…”

Section: Race Influence On Access and Quality Of Carementioning

confidence: 99%

“…

It is now well documented that there are profound race-associated disparities among those who are affected by and die from cardiovascular disease (CVD) [1]. These disparities are deeply rooted within the history of race and medicine in the US.

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mentioning

confidence: 99%

Race, Discrimination, and Cardiovascular Disease

2014

AMA Journal of Ethics

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“…The quality of cardiovascular care for racial and ethnic minorities is known to vary (9). The rate of preventable hospitalizations for conditions that include HF is highest for black and Hispanic subjects compared with white subjects (10).…”

mentioning

confidence: 99%

Race/Ethnic Differences in Outcomes Among Hospitalized Medicare Patients With Heart Failure and Preserved Ejection Fraction

Ziaeian

Heidenreich

et al. 2017

JACC: Heart Failure

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OBJECTIVES This study analyzed HFpEF patient characteristics and clinical outcomes according to race/ethnicity and adjusted for patient and hospital characteristics along with socioeconomic status (SES). BACKGROUND The proportion of hospitalizations for heart failure with preserved ejection fraction (HFpEF) has increased over the last decade. Whether the short- and long-term outcomes differ between racial/ethnic groups is not well described. METHODS The Get With The Guidelines–Heart Failure registry was linked to Medicare administrative data to identify hospitalized patients with HFpEF ≥65 years of age with left ventricular ejection fraction ≥50% between 2006 and 2014. Cox proportional hazards models were used to report hazard ratios (HRs) for 30-day and 1-year readmission and mortality rates with sequential adjustments for patient characteristics, hospital characteristics, and SES. RESULTS The final cohort included 53,065 patients with HFpEF. Overall 30-day mortality was 5.87%; at 1 year, it was 33.1%. The 30-day all-cause readmission rate was 22.2%, and it was 67.0% at 1 year. After adjusting for patient characteristics, hospital characteristics, and SES, 30-day mortality was lower for black patients (HR: 0.84; 95% confidence interval [CI]: 0.71 to 0.98; p = 0.031) and Hispanic patients (HR: 0.78; 95% CI: 0.64 to 0.96; p = 0.017) compared with white patients. One-year mortality was lower for black patients (HR: 0.93; 95% CI: 0.87 to 0.99; p = 0.031), Hispanic patients (HR: 0.83; 95% CI: 0.75 to 0.91; p < 0.001), and Asian patients (HR: 0.76; 95% CI: 0.66 to 0.88; p < 0.001) compared with white patients. Black patients had a higher risk of readmission at 30 days (HR: 1.09; 95% CI: 1.02 to 1.16; p = 0.012) and 1 year (HR: 1.14; 95% CI: 1.09 to 1.20; p < 0.001) compared with white patients. CONCLUSIONS Black, Hispanic, and Asian patients had a lower mortality risk after a hospitalization for HFpEF compared with white patients; black patients had higher readmission rates. These differences in mortality and readmission risk according to race/ethnicity persisted after adjusting for patient characteristics, SES, and hospital factors.

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Most Important Articles on Cardiovascular Disease Among Racial and Ethnic Minorities

Cited by 38 publications

References 55 publications

Measuring Physical Activity With Implanted Cardiac Devices: A Systematic Review

Measuring Physical Activity With Implanted Cardiac Devices: A Systematic Review

Race, Discrimination, and Cardiovascular Disease

Race/Ethnic Differences in Outcomes Among Hospitalized Medicare Patients With Heart Failure and Preserved Ejection Fraction

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