Evidence map›Paper›PMID 37389504›Full record

ArticleJACC. Heart failure2023

Racial and Ethnic Disparities in Ambulatory Heart Failure Ventricular Assist Device Implantation and Survival.

Debra D Dixon, Shannon M Knapp, Onyedika Ilonze, Sabra C Lewsey, Sula Mazimba, Selma Mohammed, Harriette G C Van Spall, Khadijah Breathett

Open access · greenAbstract read
In one paragraph

Article in JACC. Heart failure, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 2 countries.

Debra D DixonDivision of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Shannon M KnappDivision of Cardiovascular Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Onyedika IlonzeDivision of Cardiovascular Medicine, Krannert Cardiovascular Research Center, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Sabra C LewseyDivision of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Sula MazimbaDivision of Cardiovascular Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Selma MohammedDivision of Cardiovascular Medicine, Creighton University School of Medicine, Omaha, Nebraska, USA.
Harriette G C Van SpallDepartment of Medicine, Department of Health Research Methods, Evidence, and Impact, McMaster University School of Medicine, Hamilton, Ontario, Canada.
Khadijah BreathettDivision of Cardiovascular Medicine, Krannert Cardiovascular Research Center, Indiana University School of Medicine, Indianapolis, Indiana, USA. Electronic address: kbreath@iu.edu.
Indiana University School of MedicineCreighton University · USImpact · CAJohns Hopkins University · USUniversity of Virginia · USVanderbilt University Medical Center · US

Funding

Training In Cardiovascular ResearchT32HL007411 · NHLBI · VANDERBILT UNIVERSITY · PI BECKMAN, JOSHUA A · 1985 to 2020
$7.2M
Mitochondrial energetics, exercise intolerance and fatigability in older people with HIVR01AG063661 · NIA · JOHNS HOPKINS UNIVERSITY · PI WEISS, ROBERT G · 2019 to 2024
$3.3M
Seeking Objectivity in Allocation of Advanced Heart Failure (SOCIAL HF) Therapies TrialR01HL159216 · NHLBI · INDIANA UNIVERSITY INDIANAPOLIS · PI BREATHETT, KHADIJAH · 2022 to 2025
$2.6M
Seeking Objectivity in Allocation of Advanced Heart Failure (SOCIAL HF) Therapies TrialR56HL159216 · NHLBI · UNIVERSITY OF ARIZONA · PI BREATHETT, KHADIJAH · 2021 to 2021
$906k
Addressing Individual Provider Bias and Group Decision-Making in Selection of Advanced Heart Failure Therapies in Racial/Ethnic MinoritiesK01HL142848 · NHLBI · UNIVERSITY OF ARIZONA · PI BREATHETT, KHADIJAH · 2018 to 2021
$858k
NHLBI NIH HHS K01 HL142848NHLBI NIH HHS L30 HL148881NHLBI NIH HHS R01 HL159216NHLBI NIH HHS R56 HL159216NHLBI NIH HHS T32 HL007411NIA NIH HHS R01 AG063661
6 · The paper itself

Abstract

backgroundDurable left ventricular assist devices (VADs) improve survival in eligible patients, but allocation has been associated with patient race in addition to presumed heart failure (HF) severity.

objectivesThis study sought to determine racial and ethnic differences in VAD implantation rates and post-VAD survival among patients with ambulatory HF.

methodsUsing the INTERMACS (Interagency Registry of Mechanically Assisted Circulatory Support) database (2012-2017), this study examined census-adjusted VAD implantation rates by race, ethnicity, and sex in patients with ambulatory HF (INTERMACS profile 4-7) using negative binomial models with quadratic effect of time. Survival was evaluated using Kaplan-Meier estimates and Cox models adjusted for clinically relevant variables and an interaction of time with race/ethnicity.

resultsVADs were implanted in 2,256 adult patients with ambulatory HF (78.3% White, 16.4% Black, and 5.3% Hispanic). The median age at implantation was lowest in Black patients. Implantation rates peaked between 2013 and 2015 before declining in all demographic groups. From 2012 to 2017, implantation rates overlapped for Black and White patients but were lower for Hispanic patients. Post-VAD survival was significantly different among the 3 groups (log rank P = 0.0067), with higher estimated survival among Black vs White patients (12-month survival: Black patients: 90% [95% CI: 86%-93%]; White patients: 82% [95% CI: 80%-84%]). Low sample size for Hispanic patients resulted in imprecise survival estimates (12-month survival: 85% [95% CI: 76%-90%]).

conclusionsBlack and White patients with ambulatory HF had similar VAD implantation rates but rates were lower for Hispanic patients. Survival differed among the 3 groups, with the highest estimated survival at 12 months in Black patients. Given higher HF burden in minoritized populations, further investigation is needed to understand differences in VAD implantation rates in Black and Hispanic patients.

Indexed as

Heart-Assist DevicesHeart FailureAdultHumansKaplan-Meier EstimateProportional Hazards ModelsRegistriesTreatment Outcomeambulatory heart failurehealth disparitiesheart failureINTERMACS profileracial disparitiesventricular assist device

Identifiers

PMID37389504
PMCPMC10614028
OpenAlexW4382364218

What OpenQuestion holds

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LicenceTDM
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.