The following is a summary of “RACIAL DIFFERENCES IN THE OUTCOMES OF CATHETER ABLATION FOR ATRIAL FIBRILLATION IN PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION: ANALYSIS FROM A NATIONAL REPRESENTATIVE DATABASE,” published in the March 2023 issue of Cardiology by Agarwal, et al.
For a study, researchers sought to investigate racial differences in in-hospital outcomes of patients with heart failure with preserved ejection fraction (HFpEF) undergoing catheter ablation (CA) for atrial fibrillation (AF).
A retrospective analysis was performed using the Nationwide Inpatient Sample from 2016-2019. The study population consisted of 20,085 hospitalized patients who underwent CA for AF. Patients were categorized into four racial groups: Caucasians (81%), African Americans (8.4%), Hispanics (5.3%), and other races (2.8%). The primary outcomes assessed were in-hospital mortality, stroke, vascular complications, cardiovascular events (myocardial infarction, cardiogenic shock, cardiac arrest, cardiac tamponade requiring pericardiocentesis), major bleeding, pulmonary complications, total hospitalization charges, and length of stay (LOS).
Multivariate regression analysis was used to adjust for confounders. African Americans had significantly higher in-hospital mortality compared to other racial groups. On multivariate analysis, African Americans had higher adjusted odds of in-hospital mortality (adjusted odds ratio [aOR]: 3.3, 95% CI: 1.7-6.4, P<0.01), cardiovascular complications (aOR: 1.56, 95% CI: 1.03-2.35, P=0.03), and longer LOS (1 day longer, P<0.01). Hispanics and other races had higher hospitalization charges (40,064 dollars higher, P<0.01, and 45,858 dollars higher, P<0.01, respectively).
The study demonstrated that African Americans with HFpEF undergoing CA for AF have worse in-hospital outcomes than other racial groups. The reasons for these disparities required further investigation.