title: Impact of Race on Outcome of Patients Undergoing Rhythm Control of Atrial Fibrillation.
abstract: Racial disparities between African American (AA) and White patients have been documented in cardiovascular disease. We investigated whether these disparities exist in patients undergoing rhythm control for atrial fibrillation (AF). 5873 AF patients (241 AA) were followed to the endpoint of death, stroke, or AF recurrence. Invasive procedures for AF rhythm control were examined in both racial groups. Over a mean follow-up time of 40 months, AA patients had a higher adjusted risk of death [HR 1.39, 95% CI 1.00-1.92, p = 0.043] and stroke [HR 1.90, 95% CI 1.13-3.15, p = 0.013] but a lower risk of AF recurrence [HR 0.79, 95% CI 0.63-0.97, p = 0.026]. In addition, AA patients were less likely to undergo AF ablation (p = 0.006) or surgical maze (p = 0.032) procedures compared to White patients, possibly due to the lower rates of AF recurrence. Significant racial disparities exist in the management and outcomes of AA and White patients undergoing rhythm control management for AF.
authors.affiliation: Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Asad F
authors.initials: AF
authors.lastname: Durrani
authors.affiliation: Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Siva
authors.initials: S
authors.lastname: Soma
authors.affiliation: Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Althouse
authors.affiliation: Department of Medicine, Stanford University, Palo Alto, CA, USA.
authors.forename: George
authors.initials: G
authors.lastname: Leef
authors.affiliation: Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Dingxin
authors.initials: D
authors.lastname: Qin
authors.affiliation: Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. sabas@upmc.edu.|UPMC Presbyterian, 200 Lothrop Street, Suite B 535, Pittsburgh, PA, 15213, USA. sabas@upmc.edu.
authors.forename: Samir
authors.initials: S
authors.lastname: Saba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000628:therapy*; D003643:Death; D054624:Health Status Disparities; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D044469:Racial Groups; D012042:Registries; D020521:Stroke
keywords: Atrial fibrillation; Death; Outcomes; Race; Stroke