Date of Award

1-28-2009

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Ike Okosun - Chair

Abstract

Objective: The aim of this study was to determine the role of race as a significant risk factor for prediction of outcomes in heart failure (HF). Methods: The data was collected on demographics, detailed history of HF, family history, vital signs, medication and laboratory profile for 585 patients from Heart failure Treatment Center of Emory University after year of 2000. Outcome of HF was defined as combination of death, placement of left ventricular assisted devise, heart transplant or emergency transplant. The independent relationship between race and outcomes of HF was evaluated by univariate and multivariate logistic regression analyses. The survival analysis was done by Cox regression modeling. Results: Among 585 HF patients, 58.1% were whites and 41.9% were blacks and 28.2% HF patients had positive outcomes. Although Whites tended to have a more positive outcome (34.6%) than blacks (28.9%), the difference was not statistically significant. Factors predicting the outcome in whites were male gender (OR 5.02), history of hypertension (OR 2.3), ventricular arrhythmias (OR 2.4), placement of AICD(OR 0.09), low EF% (OR 0.95), high NYHA class (OR 3.25), use of beta blockers (OR 0.12), aldosterone blockers (OR 2.19), furosemide (2.18); while in blacks they were age in years (OR 0.96), history of PTCA (OR 7.04), dislipidemia (OR 3.90), depression (OR 0.01), placement of AICD (OR 0.14), low EF% (OR 0.92), systolic blood pressure (OR 0.96), high NYHA class (OR 4.01), use of beta blockers (OR 0.14), torsemide (OR 2.86), and digoxin (OR 4.91) etc. Blacks had higher survival than whites (p < 0.001). Conclusion: There is no significant difference in combined outcome (death, transplant, emergency transplant, and Left Ventricular Assisted Devise placement) of HF between whites and blacks. There are differences regarding the risk factors, which are more prominent in each race. Further exploration is required to evaluate the race as significant risk factor for predicting the outcome in HF.

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