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Race and Ethnic and Sex Differences in Rhythm Control Treatment of Incident Atrial Fibrillation

BACKGROUND: Atrial fibrillation (AF) is associated with considerable morbidity and mortality. Timely management and treatment is critical in alleviating AF disease burden. Variation in treatment by race and ethnic and sex could lead to inequities in health outcomes. OBJECTIVE: To identify racial and...

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Autores principales: Jackson II, Larry R, Friedman, Daniel J, Francis, Diane M, Maccioni, Sonia, Thomas, Vincent C, Coplan, Paul, Khanna, Rahul, Wong, Charlene, Rahai, Neloufar, Piccini, Jonathan P
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237629/
https://www.ncbi.nlm.nih.gov/pubmed/37273820
http://dx.doi.org/10.2147/CEOR.S402344
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author Jackson II, Larry R
Friedman, Daniel J
Francis, Diane M
Maccioni, Sonia
Thomas, Vincent C
Coplan, Paul
Khanna, Rahul
Wong, Charlene
Rahai, Neloufar
Piccini, Jonathan P
author_facet Jackson II, Larry R
Friedman, Daniel J
Francis, Diane M
Maccioni, Sonia
Thomas, Vincent C
Coplan, Paul
Khanna, Rahul
Wong, Charlene
Rahai, Neloufar
Piccini, Jonathan P
author_sort Jackson II, Larry R
collection PubMed
description BACKGROUND: Atrial fibrillation (AF) is associated with considerable morbidity and mortality. Timely management and treatment is critical in alleviating AF disease burden. Variation in treatment by race and ethnic and sex could lead to inequities in health outcomes. OBJECTIVE: To identify racial and ethnic and sex differences in rhythm treatment for patients with incident AF. METHODS: Using 2010–2019 Optum Clinformatics database, an administrative claims data for commercially insured patients in the United States (US), incident AF patients ≥20 years old who were continuously enrolled 12-months pre- and post-index diagnosis were identified. Rhythm control treatment (ablation, antiarrhythmic drugs [AAD], and cardioversion) for AF were compared by patient race and ethnicity (Asian, Hispanic, Black vs White) and sex (female vs male). Multivariable regression analysis was used to examine the relationship of race and ethnicity and sex with rhythm control AF treatment. RESULTS: A total of 77,932 patients were identified with incident AF. Black and Hispanic female patients had the highest CHA(2)DS(2)VASc scores (4.3 ± 1.8) and Elixhauser scores (4.1 ± 2.8 and 4.0 ± 6.7), respectively. Black males were less likely to receive AAD treatment (adjusted odds ratio [aOR] 0.87; 95% confidence interval [CI], 0.79–0.96) or ablation (aOR, 0.72; 95% CI, 0.58–0.90). Compared to White males, all groups had lower likelihood of receiving cardioversion with Asian females having the lowest [aOR, 0.48; 95% CI, (0.37–0.63)]. CONCLUSION: Black patients were less likely to receive pharmacologic and procedural rhythm control therapies. Further research is needed to understand the drivers of undertreatment among racial and ethnic groups and females with AF.
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spelling pubmed-102376292023-06-03 Race and Ethnic and Sex Differences in Rhythm Control Treatment of Incident Atrial Fibrillation Jackson II, Larry R Friedman, Daniel J Francis, Diane M Maccioni, Sonia Thomas, Vincent C Coplan, Paul Khanna, Rahul Wong, Charlene Rahai, Neloufar Piccini, Jonathan P Clinicoecon Outcomes Res Original Research BACKGROUND: Atrial fibrillation (AF) is associated with considerable morbidity and mortality. Timely management and treatment is critical in alleviating AF disease burden. Variation in treatment by race and ethnic and sex could lead to inequities in health outcomes. OBJECTIVE: To identify racial and ethnic and sex differences in rhythm treatment for patients with incident AF. METHODS: Using 2010–2019 Optum Clinformatics database, an administrative claims data for commercially insured patients in the United States (US), incident AF patients ≥20 years old who were continuously enrolled 12-months pre- and post-index diagnosis were identified. Rhythm control treatment (ablation, antiarrhythmic drugs [AAD], and cardioversion) for AF were compared by patient race and ethnicity (Asian, Hispanic, Black vs White) and sex (female vs male). Multivariable regression analysis was used to examine the relationship of race and ethnicity and sex with rhythm control AF treatment. RESULTS: A total of 77,932 patients were identified with incident AF. Black and Hispanic female patients had the highest CHA(2)DS(2)VASc scores (4.3 ± 1.8) and Elixhauser scores (4.1 ± 2.8 and 4.0 ± 6.7), respectively. Black males were less likely to receive AAD treatment (adjusted odds ratio [aOR] 0.87; 95% confidence interval [CI], 0.79–0.96) or ablation (aOR, 0.72; 95% CI, 0.58–0.90). Compared to White males, all groups had lower likelihood of receiving cardioversion with Asian females having the lowest [aOR, 0.48; 95% CI, (0.37–0.63)]. CONCLUSION: Black patients were less likely to receive pharmacologic and procedural rhythm control therapies. Further research is needed to understand the drivers of undertreatment among racial and ethnic groups and females with AF. Dove 2023-05-29 /pmc/articles/PMC10237629/ /pubmed/37273820 http://dx.doi.org/10.2147/CEOR.S402344 Text en © 2023 Jackson II et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Jackson II, Larry R
Friedman, Daniel J
Francis, Diane M
Maccioni, Sonia
Thomas, Vincent C
Coplan, Paul
Khanna, Rahul
Wong, Charlene
Rahai, Neloufar
Piccini, Jonathan P
Race and Ethnic and Sex Differences in Rhythm Control Treatment of Incident Atrial Fibrillation
title Race and Ethnic and Sex Differences in Rhythm Control Treatment of Incident Atrial Fibrillation
title_full Race and Ethnic and Sex Differences in Rhythm Control Treatment of Incident Atrial Fibrillation
title_fullStr Race and Ethnic and Sex Differences in Rhythm Control Treatment of Incident Atrial Fibrillation
title_full_unstemmed Race and Ethnic and Sex Differences in Rhythm Control Treatment of Incident Atrial Fibrillation
title_short Race and Ethnic and Sex Differences in Rhythm Control Treatment of Incident Atrial Fibrillation
title_sort race and ethnic and sex differences in rhythm control treatment of incident atrial fibrillation
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237629/
https://www.ncbi.nlm.nih.gov/pubmed/37273820
http://dx.doi.org/10.2147/CEOR.S402344
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