News | March 06, 2009

Minority Patients Less Likely to Receive Treatment for Advanced Heart Failure

March 6, 2009 – New research published in the March edition of the HeartRhythm Journal reveals that black and Hispanic patients who were eligible for cardiac resynchronization therapy with defibrillator (CRT-D) were less likely to receive therapy than eligible white patients.

The study also found that both minority groups were more likely to meet established criteria and white patients were more likely to receive CRT-D outside of published guidelines. The new study is the first of its kind to examine and compare Hispanic, white and black patients within a national study population.

The national study examined 108,341 participants in more than 1,000 hospitals enrolled in the National Cardiovascular Data Registry (NCDR) from January 2005 through April 2007. The NCDR ICD Registry, developed in collaboration with the American College of Cardiology and the Heart Rhythm Society, was examined for racial and ethnic disparities in CRT-D implantation.

Lead author Steven A. Farmer, M.D., Cardiovascular Division at the Hospital of the University of Pennsylvania in Philadelphia, reviewed the data and the number of patients who met established guidelines. Of the 108,341 registry participants:

- 22,205 patients met guidelines to receive an ICD or CRT-D
- 27,165 patients received CRT-D therapy, more than the actual number of people who were eligible.

Results conclude that CRT-eligible black and Hispanic patients were less likely to receive CRT-D than were white patients. A substantial proportion of patients received CRT-D outside of published guidelines, although black and Hispanic patients were more likely to meet all eligibility criteria.

“These results reinforce a number of questions about how race and ethnicity can impact who receives advanced treatment for heart failure,” Dr. Farmer stated. “It is very surprising that there are a significant number of ICD patients who meet the required criteria for CRT-D and are not receiving the therapy, while many patients who receive the treatment fail to meet those same guidelines.”

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