학술논문
Racial disparities among patients with cardiac sarcoidosis and arrhythmias in the United States: A propensity matched-analysis from the national inpatient sample database 2016-2020.
Document Type
Academic Journal
Author
Ahmed R; Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College London, United Kingdom.; Shahbaz H; Dow University of Health Sciences, Karachi, Pakistan.; Ramphul K; Independent Researcher, Triolet, Mauritius.; Mactaggart S; Northumbria Hospitals, NHS Foundation Trust, Newcastle upon Tyne, United Kingdom. Electronic address: seb.mactaggart@hotmail.com.; Dulay MS; Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, United Kingdom.; Okafor J; Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, United Kingdom.; Azzu A; Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, United Kingdom.; Khattar R; Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, United Kingdom.; Wells AU; Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, United Kingdom.; Wechalekar K; Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, United Kingdom.; Kouranos V; Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, United Kingdom.; Chahal A; Department of Cardiology, Barts Heart Centre, London, United Kingdom; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA; Center for Inherited Cardiovascular Diseases, Department of Cardiology, Wellspan Health, York, PA 17403, USA.; Sharma R; Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College London, United Kingdom.
Source
Publisher: Elsevier Country of Publication: Netherlands NLM ID: 7701802 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-6280 (Electronic) Linking ISSN: 01462806 NLM ISO Abbreviation: Curr Probl Cardiol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Cardiac sarcoidosis (CS) is frequently associated with conduction abnormalities and arrhythmias. In this study, we aim to evaluate racial disparities in the frequency of arrhythmias, and associated co-morbidities, among patients with CS.
Methods: White and African American (AA) patients diagnosed with CS were identified and compared from the 2016-2020 National Inpatient Sample (NIS) database whilst adjusting for confounders via logistic regression models.
Results: A total of 7,935 patients with CS were included in the study. The propensity-matched sample comprised of 5,570 patients, of whom 2,785 were White and 2,785 were AA. AA patients had a longer mean length of hospital stay (LOS) (7.84 vs. 6.94, p<0.01), a higher mean Charlson Comorbidity Index (CCI) score (3.10 vs. 2.84, p<0.01), and significantly higher incidences of cardiogenic shock [(9.2% vs 6.3%, p<0.01), aOR 1.45 (95% CI 1.17-1.78), p<0.01] and acute kidney injury (AKI) [(34.3% vs. 26.9%, p<0.01), aOR 1.41 (95% CI 1.24-1.61), p<0.01]. From an arrhythmia perspective, AA CS patients were shown to have a lower frequency of: (1) ventricular tachycardia (32.5% vs. 37.9%, p<0.01), (2) ventricular fibrillation (5.4% vs.7.2%, p<0.01), (3) first-degree AV block (1.8% vs. 4.1%, p<0.01), (4) complete AV block (6.3% vs. 14.2%, p<0.01), and (5) atrial fibrillation (31.8% vs. 34.8%, p=0.016) when compared to Whites with CS. Mortality remained higher for AAs (3.8% vs. 2.7%, p=0.024).
Conclusion: Our study demonstrates a higher incidence of cardiac arrhythmias among White patients but a higher incidence of cardiogenic shock, AKI, mean LOS, and mortality among AA patients with cardiac sarcoidosis.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Methods: White and African American (AA) patients diagnosed with CS were identified and compared from the 2016-2020 National Inpatient Sample (NIS) database whilst adjusting for confounders via logistic regression models.
Results: A total of 7,935 patients with CS were included in the study. The propensity-matched sample comprised of 5,570 patients, of whom 2,785 were White and 2,785 were AA. AA patients had a longer mean length of hospital stay (LOS) (7.84 vs. 6.94, p<0.01), a higher mean Charlson Comorbidity Index (CCI) score (3.10 vs. 2.84, p<0.01), and significantly higher incidences of cardiogenic shock [(9.2% vs 6.3%, p<0.01), aOR 1.45 (95% CI 1.17-1.78), p<0.01] and acute kidney injury (AKI) [(34.3% vs. 26.9%, p<0.01), aOR 1.41 (95% CI 1.24-1.61), p<0.01]. From an arrhythmia perspective, AA CS patients were shown to have a lower frequency of: (1) ventricular tachycardia (32.5% vs. 37.9%, p<0.01), (2) ventricular fibrillation (5.4% vs.7.2%, p<0.01), (3) first-degree AV block (1.8% vs. 4.1%, p<0.01), (4) complete AV block (6.3% vs. 14.2%, p<0.01), and (5) atrial fibrillation (31.8% vs. 34.8%, p=0.016) when compared to Whites with CS. Mortality remained higher for AAs (3.8% vs. 2.7%, p=0.024).
Conclusion: Our study demonstrates a higher incidence of cardiac arrhythmias among White patients but a higher incidence of cardiogenic shock, AKI, mean LOS, and mortality among AA patients with cardiac sarcoidosis.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)