HF quality of care poorer among Asian vs White patients in US

Quality of care for heart failure (HF) patients varies, with substantial gaps among Asians compared with non-Hispanic Whites, reports a US study.

A total of 824 US hospitals from the Get With The Guidelines‒Heart Failure registry (2015‒2023) were included in the study. The investigators assessed the odds of optimal medical therapy (OMT), defined as an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker or angiotensin receptor-neprilysin inhibitor for those with an ejection fraction (EF) ≤40 percent; a beta-blocker for those with an EF ≤40 percent; and mineralocorticoid receptor antagonist for those with an EF ≤35 percent, at discharge for HF with reduced EF, and length of stay (LOS) >4 days, defect-free care (OMT, follow-up visit scheduling, HF education) at discharge, and in-hospital mortality among patients with any EF.

Participants were classified into the following cohorts: Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, and Other Asian vs non-Hispanic Whites.

Overall, 7,261 Asian patients (mean age 69.9‒78.8 years, 41‒51 percent female) and 768,566 non-Hispanic White patients (mean age 74.6 years, 47 percent female) were included.

Vietnamese male patients were less likely to receive OMT (adjusted OR [aOR], 0.68, 95 percent confidence interval [CI], 0.47‒1.00) than their White counterparts, while the odds of longer LOS (>4 days) were lower among Vietnamese male patients (aOR, 0.68, 95 percent CI, 0.50‒0.91) and Filipino female patients (aOR, 0.66, 95 percent CI, 0.46‒0.95). Furthermore, Filipino female patients had a lower likelihood of receiving defect-free care (aOR, 0.52, 95 percent CI, 0.34‒0.82).

In-hospital mortality, however, showed no significant difference between Asian and non-Hispanic White patients. A significant heterogeneity was observed in frequency of LOS >4 days and defect-free care across female Asian patient groups.