Disparities by Sex, Race, and Ethnicity in Use of Left Ventricular Assist Devices and Heart Transplants Among Patients With Heart Failure With Reduced Ejection Fraction

The extent to which sex, racial, and ethnic groups receive advanced heart therapies equitably is unclear. We estimated the population rate of left ventricular assist device (LVAD) and heart transplant (HT) use among (non-Hispanic) White, Hispanic, and (non-Hispanic) Black men and women who have hear...

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Bibliographic Details
Published in:Journal of the American Heart Association 2024-01, Vol.13 (2), p.e031021-e031021
Main Authors: Rose, Scott W, Strackman, Braden W, Gilbert, Olivia N, Lasser, Karen E, Paasche-Orlow, Michael K, Lin, Meng-Yun, Saylor, Georgia, Hanchate, Amresh D
Format: Article
Language:English
Subjects:
Adult
Ethnicity
Female
heart failure
Heart Failure - surgery
heart transplant
Heart Transplantation
Heart-Assist Devices
Humans
left ventricular assist device
Male
Original Research
race
reduced ejection fraction
Retrospective Studies
Stroke Volume
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Summary:The extent to which sex, racial, and ethnic groups receive advanced heart therapies equitably is unclear. We estimated the population rate of left ventricular assist device (LVAD) and heart transplant (HT) use among (non-Hispanic) White, Hispanic, and (non-Hispanic) Black men and women who have heart failure with reduced ejection fraction (HFrEF). We used a retrospective cohort design combining counts of LVAD and HT procedures from 19 state inpatient discharge databases from 2010 to 2018 with counts of adults with HFrEF. Our primary outcome measures were the number of LVAD and HT procedures per 1000 adults with HFrEF. The main exposures were sex, race, ethnicity, and age. We used Poisson regression models to estimate procedure rates adjusted for differences in age, sex, race, and ethnicity. In 2018, the estimated population of adults aged 35 to 84 years with HFrEF was 69 736, of whom 44% were women. Among men, the LVAD rate was 45.6, and the HT rate was 26.9. Relative to men, LVAD and HT rates were 72% and 62% lower among women (
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.123.031021