title: Care and outcomes of Hispanic patients admitted with heart failure with preserved or reduced ejection fraction: findings from get with the guidelines-heart failure.
abstract: BACKGROUND
  Although individuals of Hispanic ethnicity are at high risk for developing heart failure (HF), little is known about differences between Hispanic HF patients stratified by left ventricular ejection fraction (EF). We compared characteristics, quality of care, and outcomes between Hispanic and non-Hispanic white patients hospitalized for HF with preserved EF (PEF) or reduced EF (REF).
  
  
  RESULTS
  From 247 hospitals in Get With The Guidelines-Heart Failure between 2005-2010, 6117 Hispanics were compared with 71 859 non-Hispanic whites. Forty-six percent of Hispanics had PEF (EF >40%), whereas 54% had REF (EF <40%); 55% and 45% of non-Hispanic whites had PEF and REF, respectively. Relative to non-Hispanic whites, Hispanics with PEF or REF were more likely to be younger and to have diabetes, hypertension, and overweight/obesity. In multivariate analysis, a lower mortality risk was observed among Hispanics with PEF (odds ratio, 0.50; 95% confidence interval, 0.31-0.81; P=0.005) but not in Hispanics with REF (odds ratio, 0.94; 95% confidence interval, 0.62-1.43; P=0.784) compared with non-Hispanic whites. In all groups, composite performance improved within the study period (Hispanics PEF: 75.2-95.1%; non-Hispanic whites PEF: 79.0-92.7%; Hispanics REF: 67.7-88.4%; non-Hispanic whites REF: 60.8-85.6%, P<0.0001).
  
  
  CONCLUSIONS
  Hispanic HF patients with PEF had better in-hospital survival than non-Hispanic whites with PEF. Inpatient mortality was similar between groups with REF. Quality of care was similar and improved over time irrespective of ethnicity, highlighting the potential benefit of performance improvement programs in promoting equitable care.
authors.affiliation: University of Texas Medical Branch, Galveston, and Methodist DeBakey Heart and Vascular Center, Houston, TX 77555-0144, USA. rpvivo@gmail.com
authors.forename: Rey P
authors.initials: RP
authors.lastname: Vivo
authors.forename: Selim R
authors.initials: SR
authors.lastname: Krim
authors.forename: Nassim R
authors.initials: NR
authors.lastname: Krim
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Hernandez
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.forename: Ileana L
authors.initials: IL
authors.lastname: Piña
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.forename: Lee H
authors.initials: LH
authors.lastname: Schwamm
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000208:ethnology / Q000503:physiopathology / Q000628:therapy*; D006630:Hispanic or Latino; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011379:Prognosis; D011787:Quality of Health Care / Q000592:standards*; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology*; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D016277:Ventricular Function, Left / Q000502:physiology*