RACIAL AND ETHNIC DISPARITIES IN HEART TRANSPLANT PATIENTS WITH CORONARY ARTERY DISEASE

Abstract

Therapeutic Area: ASCVD/CVD in Special Populations Background: The complexities faced by patients with coronary artery disease (CAD) with heart transplantation are underscored by pronounced racial and ethnic disparities influencing both clinical and socioeconomic outcomes. These disparities highlight the need for a deeper examination of the economic impacts and variations in mortality rates among these patients. Through this study, we aim to uncover the extent of these disparities to advocate for equitable healthcare solutions and improved patient care strategies across diverse racial and ethnic groups. Methods: We analyzed the National Inpatient Sample from 2016 to 2020, identifying patients with CAD and secondary Heart Transplant diagnoses via ICD-10 codes. Multivariate logistic regression was used to analyze outcomes and mortality while adjusting for confounders. Outcomes are presented as odds ratios (ORs) with 95% confidence intervals (CIs) and p-values. Results: A total of 157730 patients had CAD and heart transplants. The mean age was 67, and predominately female (82%). However, Blacks and Native Americans were younger, with a mean age of 61. In the low-income bracket, 50% were Black patients, 43 % Native American, and 35% Hispanic patients. The mean Total charge (TOTCHG) was $96744. Black patients had a TOTCHG of $131375, Hispanics had $180444, Asians had $186876, and Native Americans had $107776 compared to white $103176. The mean length of Stay for Black patients was 9.5 days, Hispanics 9 days, Asians 10.5 days, and Native Americans 9 days compared to white patients was 7.3 days. Mortality in Blacks was 9.2% (OR 1.3 95% Cl 1.12 – 1.49 p<0.001), Hispanic 10.0% (OR 1.4 95% Cl 1.22 – 1.66 p<0.001), Asian 13.8% (OR 1.9 95% Cl 1.55 – 2.45 p<0.001), Native American 8.0% (OR 1.2 95% Cl 0.66 – 2.02 p< 0.001) compared to 7.2% of white patients. Conclusions: Our findings reveal significant racial and ethnic disparities, with Asian patients having the highest mortality and experiencing increased healthcare costs and length of stay. Followed by Hispanic, Black, and Native American patients. These disparities underscore the need for targeted healthcare interventions and further research to understand and address the barriers to equitable care.