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Advanced heart failure therapies (AHFT) such as Ventricular Assist Devices and transplant prolong survival and improve quality of life. Few studies exist investigating the clinical and socio-economic profiles of patients being considered for AHFT.
The medical records and transplant meeting minutes for all patients considered for AHFT's from 2007 to 2010 were reviewed.
African Americans (AA's) were accepted for AHFT less often than Caucasians (CA's): 47.5% (38/80) vs. 65.7% (71/108), p=0.012. AA's were younger (p>0.001), had more former and current illicit drug use (p=0.002), and were more frequently unmarried (p=0.008). AA's were denied more often for social reasons (p=0.002) with significantly more non-compliance, drug use, and poor social support. Heart failure etiology (ischemic vs. non-ischemic [NI]) (p=0.32) and affluence (residence zip code median income > $50,000 vs. <$50,000) (p=0.35) did not impact acceptance for AHFT. AA's were more likely to have a NI etiology (81%) than CA's (32%), p<0.001, and to live in less affluent zip codes, p<0.001; these AA's were rejected more often for AHFT compared to their CA counterparts, p=0.01 and p=0.04 respectively.
AA's were rejected for AHFT more frequently than CA's. Rejected AA's were younger, had more drug use, and were rejected more often for social issues. Heart failure etiology and affluence did not independently affect acceptance for AHFT. AA's with NI etiology or who lived in less affluent zip codes were denied AHFT's more frequently than their CA counterparts. Future studies and interventions should examine these issues to improve the candidacy of AA's for AHFT.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Challenges and Clinical Outcomes in Cardiac Transplantation
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1309-312
- 2013 American College of Cardiology Foundation