Racial/ethnic differences in b-type natriuretic peptide levels and their association with care and outcomes among patients hospitalized with heart failure: Findings from get with the guidelines-heart failure

Krim, Selim R., Vivo, Rey P., Krim, Nassim R., Qian, Feng, Cox, Margueritte, Ventura, Hector, Hernandez, Adrian F., Bhatt, Deepak L. and Fonarow, Gregg C. (2013) Racial/ethnic differences in b-type natriuretic peptide levels and their association with care and outcomes among patients hospitalized with heart failure: Findings from get with the guidelines-heart failure. JACC: Heart Failure, 1 4: 345-352. doi:10.1016/j.jchf.2013.04.008

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Author Krim, Selim R.
Vivo, Rey P.
Krim, Nassim R.
Qian, Feng
Cox, Margueritte
Ventura, Hector
Hernandez, Adrian F.
Bhatt, Deepak L.
Fonarow, Gregg C.
Title Racial/ethnic differences in b-type natriuretic peptide levels and their association with care and outcomes among patients hospitalized with heart failure: Findings from get with the guidelines-heart failure
Journal name JACC: Heart Failure   Check publisher's open access policy
ISSN 2213-1779
2213-1787
Publication date 2013-08-01
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.jchf.2013.04.008
Volume 1
Issue 4
Start page 345
End page 352
Total pages 8
Place of publication New York, NY United States
Publisher Elsevier Inc.
Collection year 2014
Language eng
Subject 2705 Cardiology and Cardiovascular Medicine
Abstract Objectives: This study sought to determine if there were differences in B-type natriuretic peptide (BNP) levels across racial/ethnic groups and in their association with quality of care and in-hospital outcomes among patients with heart failure (HF). Background: It remains unclear whether BNP levels and their associations with quality of care and prognosis vary by race/ethnicity among patients hospitalized with HF. Methods: Using Get With The Guidelines-Heart Failure (GWTG-HF), patient characteristics and BNP levels at admission were compared among 4 racial/ethnic populations: white, black, Hispanic, and Asian. The associations between BNP, quality of care, in-hospital mortality, and length of stay (LOS) across these groups were analyzed. Results: A total of 92,072 patients (65,037 white, 19,092 black, 6,747 Hispanic, and 1,196 Asian) from 264 hospitals were included. Median BNP levels were higher in Asian (1,066 pg/ml) and black (866 pg/ml) patients than in white (776pg/ml) and Hispanic (737 pg/ml) patients, and race/ethnicity was independently associated with BNP levels (p< 0.0001). Irrespective of race/ethnicity, patients in higher BNP quartiles (Q3, Q4) were more likely to be older and male and have lower body mass index, reduced ejection fraction, and renal insufficiency, whereas those in the lowest quartile (Q1) were more likely to have diabetes. With some exceptions, there were no significant racial/ethnic differences in the association of BNP levels with performance measure adherence. In multivariate analysis, elevated BNP levels remained associated with longer LOS and increased mortality in all racial/ethnic groups. Conclusions: Asian and black patients with HF had higher BNP levels at admission compared with white and Hispanic patients. BNP levels at admission provided prognostic value for in-hospital mortality and hospital LOS irrespective of race/ethnicity.
Keyword BNP
Heart failure
Outcome
Quality of care
Race
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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Created: Tue, 29 Apr 2014, 09:30:18 EST by Matthew Lamb on behalf of School of Medicine