Higher Mortality in African Americans Hospitalized with Heart Failure

Introduction: Predictors of mortality in systolic heart failure (HF) have not been well characterized in African Americans. Methods: We studied 312 patients hospitalized with systolic HF in urban hospital between Jan and May-2007. Mortality was the primary outcome. We analyzed variables like clinical characteristics, co-morbidities, and laboratory findings. Multi-variate logistic regression analysis was constructed which included all statistically significant variables (p-value ≤ 0.05). Results: The mean age was 61.7 ± 16.7. Males were 56.7%. Sixty eight patients (21.8%) died. They were older (70.5 ± 16.9 vs 59.3 ± 15.9, p=0.000), female gender (51.5% vs 41.0%, p=0.123), had lower BMI (28.0 ± 8.1 vs 30.6 ± 8.9, p=0.027), lower admission SBP (139.5 ± 34.5 vs150.7 ± 33.6, p=0.016), and admission DBP (80.1 ± 18.1 vs 91.4 ± 23.1, p=0.000). They were more likely to have PVD (16.2% vs 6.6% p=0.013), ischemic HF (54.4% vs 37.7%, p=0.013), wall motion abnormalities on echocardiogram (47.1% vs 30.7%, p=0.012), lower serum calcium on discharge (8.4 ± 0.9 vs 8.7 ± 0.6 , p= 0.003), to have serum bicarbonate level of >28meq/dl on discharge (48.5% vs 34.0%, p=0.029), GFR <60 on discharge (55.9% vs 41.8%, p=0.039), had higher MCV on admission (88.7 ± 9.9 vs 87.4 ± 7.4, p=0.233), higher MCV on discharge (89.1 ± 9.4 vs 87.6 ± 7.2, p=0.163) and higher RDW on admission (16.6 ± 2.1 vs 15.9 ± 2.0, p=0.011) and on discharge (16.9 ± 2.5 vs 15.7 ± 1.9, p=0.000). They were less likely to have new onset HF (5.9% vs 16.0%, p=0.025), or be discharged on ACEI (52.9% vs 67.2%, p=0.030).Tabled 1VariableOdds RatioP valueConfidence IntervalAge1.040.0001.02-1.06Presence of diastolic dysfunction0.440.0430.20-0.97Wall motion abnormality1.970.0331.06-3.68Discharge RDW1.360.0001.17-1.59Discharge MCV1.040.0251.01-1.09Discharge serum sodium bicarbonate2.060.0221.11-3.83Discharge Calcium0.650.0440.43-0.99 Open table in a new tab Introduction: Predictors of mortality in systolic heart failure (HF) have not been well characterized in African Americans. Methods: We studied 312 patients hospitalized with systolic HF in urban hospital between Jan and May-2007. Mortality was the primary outcome. We analyzed variables like clinical characteristics, co-morbidities, and laboratory findings. Multi-variate logistic regression analysis was constructed which included all statistically significant variables (p-value ≤ 0.05). Results: The mean age was 61.7 ± 16.7. Males were 56.7%. Sixty eight patients (21.8%) died. They were older (70.5 ± 16.9 vs 59.3 ± 15.9, p=0.000), female gender (51.5% vs 41.0%, p=0.123), had lower BMI (28.0 ± 8.1 vs 30.6 ± 8.9, p=0.027), lower admission SBP (139.5 ± 34.5 vs150.7 ± 33.6, p=0.016), and admission DBP (80.1 ± 18.1 vs 91.4 ± 23.1, p=0.000). They were more likely to have PVD (16.2% vs 6.6% p=0.013), ischemic HF (54.4% vs 37.7%, p=0.013), wall motion abnormalities on echocardiogram (47.1% vs 30.7%, p=0.012), lower serum calcium on discharge (8.4 ± 0.9 vs 8.7 ± 0.6 , p= 0.003), to have serum bicarbonate level of >28meq/dl on discharge (48.5% vs 34.0%, p=0.029), GFR <60 on discharge (55.9% vs 41.8%, p=0.039), had higher MCV on admission (88.7 ± 9.9 vs 87.4 ± 7.4, p=0.233), higher MCV on discharge (89.1 ± 9.4 vs 87.6 ± 7.2, p=0.163) and higher RDW on admission (16.6 ± 2.1 vs 15.9 ± 2.0, p=0.011) and on discharge (16.9 ± 2.5 vs 15.7 ± 1.9, p=0.000). They were less likely to have new onset HF (5.9% vs 16.0%, p=0.025), or be discharged on ACEI (52.9% vs 67.2%, p=0.030).