title: Characteristics, quality of care, and in-hospital outcomes of Asian-American heart failure patients: Findings from the American Heart Association Get With The Guidelines-Heart Failure Program.
abstract: BACKGROUND
  Because little was previously known about Asian-American patients with heart failure (HF), we compared clinical profiles, quality of care, and outcomes between Asian-American and non-Hispanic white HF patients using data from the American Heart Association Get With The Guidelines-Heart Failure (GWTG-HF) program.
  
  
  METHODS
  We analyzed 153,023 HF patients (149,249 whites, 97.5%; 3774 Asian-Americans, 2.5%) from 356 U.S. centers participating in the GWTG-HF program (2005-2012). Baseline characteristics, quality of care metrics, in-hospital mortality, discharge to home, and length of stay were examined.
  
  
  RESULTS
  Relative to white patients, Asian-American HF patients were younger, more likely to be male, uninsured or covered by Medicaid, and recruited in the western region. They had higher prevalence of diabetes, hypertension, and renal insufficiency, but similar ejection fraction. Overall, Asian-American HF patients had comparable quality of care except that they were less likely to receive aldosterone antagonists at discharge (relative risk <RR>, 0.88; 95% confidence interval <CI>, 0.78-0.99), and anticoagulation for atrial fibrillation (RR, 0.91; 95% CI, 0.85-0.97) even after risk adjustment. Compared with white patients, Asian-American patients had comparable risk adjusted in-hospital mortality (RR, 1.11; 95% CI, 0.91-1.35), length of stay>4 days (RR, 1.01; 95% CI, 0.95-1.08), and were more likely to be discharged to home (RR, 1.08; 95% CI, 1.06-1.11).
  
  
  CONCLUSIONS
  Despite some differences in clinical profiles, Asian-American patients hospitalized with HF receive very similar quality of care and have comparable health outcomes to their white counterparts.
authors.affiliation: University at Albany-State University of New York, Albany, United States. Electronic address: fqian@albany.edu.
authors.forename: Feng
authors.initials: F
authors.lastname: Qian
authors.affiliation: Ronald Reagan-UCLA Medical Center, Los Angeles, CA, United States.
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.affiliation: John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA, United States.
authors.forename: Selim R
authors.initials: SR
authors.lastname: Krim
authors.affiliation: Ronald Reagan-UCLA Medical Center, Los Angeles, CA, United States.
authors.forename: Rey P
authors.initials: RP
authors.lastname: Vivo
authors.affiliation: Duke University, Durham, NC, United States.
authors.forename: Margueritte
authors.initials: M
authors.lastname: Cox
authors.affiliation: University at Albany-State University of New York, Albany, United States.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Hannan
authors.affiliation: University at Albany-State University of New York, Albany, United States.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Shaw
authors.affiliation: Duke University, Durham, NC, United States.
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Hernandez
authors.affiliation: Duke University, Durham, NC, United States.
authors.forename: Zubin J
authors.initials: ZJ
authors.lastname: Eapen
authors.affiliation: Northwestern University, Chicago, IL, United States.
authors.forename: Clyde W
authors.initials: CW
authors.lastname: Yancy
authors.affiliation: VA Boston Healthcare System, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, United States.
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000572:American Heart Association; D001213:Asian / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016012:Poisson Distribution; D017410:Practice Guidelines as Topic / Q000592:standards; D011787:Quality of Health Care; D012042:Registries; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States; D044465:White People / Q000706:statistics & numerical data
keywords: Asian-American; Clinical characteristics; Heart failure; Outcome; Quality of care