Long-term cardiovascular outcomes among immigrants and non-immigrants in cardiac resynchronization therapy:a nationwide study

Autor: Krøll, Johanna, Kristensen, Søren Lund, Jespersen, Camilla H.B., Philbert, Berit, Vinther, Michael, Risum, Niels, Johansen, Jens Brock, Nielsen, Jens Cosedis, Riahi, Sam, Haarbo, Jens, Fosbøl, Emil L., Torp-Pedersen, Christian, Køber, Lars, Tfelt-Hansen, Jacob, Weeke, Peter E.
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Krøll, J, Kristensen, S L, Jespersen, C H B, Philbert, B, Vinther, M, Risum, N, Johansen, J B, Nielsen, J C, Riahi, S, Haarbo, J, Fosbøl, E L, Torp-Pedersen, C, Køber, L, Tfelt-Hansen, J & Weeke, P E 2023, ' Long-term cardiovascular outcomes among immigrants and non-immigrants in cardiac resynchronization therapy : a nationwide study ', Europace, vol. 25, no. 6, euad148 . https://doi.org/10.1093/europace/euad148
Krøll, J, Kristensen, S L, Jespersen, C H B, Philbert, B, Vinther, M, Risum, N, Johansen, J B, Nielsen, J C, Riahi, S, Haarbo, J, Fosbøl, E L, Torp-Pedersen, C, Køber, L, Tfelt-Hansen, J & Weeke, P E 2023, ' Long-term cardiovascular outcomes among immigrants and non-immigrants in cardiac resynchronization therapy : a nationwide study ', Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, vol. 25, no. 6 . https://doi.org/10.1093/europace/euad148
ISSN: 2000-2017
Popis: AimsTo date, potential differences in outcomes for immigrants and non-immigrants with a cardiac resynchronization therapy (CRT), in a European setting, remain underutilized and unknown. Hence, we examined the efficacy of CRT measured by heart failure (HF)-related hospitalizations and all-cause mortality among immigrants and non-immigrants.Methods and resultsAll immigrants and non-immigrants who underwent first-time CRT implantation in Denmark (2000–2017) were identified from nationwide registries and followed for up to 5 years. Differences in HF related hospitalizations and all-cause mortality were evaluated by Cox regression analyses. From 2000 to 2017, 369 of 10 741 (3.4%) immigrants compared with 7855 of 223 509 (3.5%) non-immigrants with a HF diagnosis underwent CRT implantation. The origins of the immigrants were Europe (61.2%), Middle East (20.1%), Asia-Pacific (11.9%), Africa (3.5%), and America (3.3%). We found similar high uptake of HF guideline-directed pharmacotherapy before and after CRT and a consistent reduction in HF-related hospitalizations the year before vs. the year after CRT (61% vs. 39% for immigrants and 57% vs. 35% for non-immigrants). No overall difference in 5-year mortality among immigrants and non-immigrants was seen after CRT [24.1% and 25.8%, respectively, P-value = 0.50, hazard ratio (HR) = 1.2, 95% confidence interval (CI): 0.8–1.7]. However, immigrants of Middle Eastern origin had a higher mortality rate (HR = 2.2, 95% CI: 1.2–4.1) compared with non-immigrants. Cardiovascular causes were responsible for the majority of deaths irrespective of immigration status (56.7% and 63.9%, respectively).ConclusionNo overall differences in efficacy of CRT in improving outcomes between immigrants and non-immigrants were identified. Although numbers were low, a higher mortality rate among immigrants of Middle Eastern origin was identified compared with non-immigrants. AIMS: To date, potential differences in outcomes for immigrants and non-immigrants with a cardiac resynchronization therapy (CRT), in a European setting, remain underutilized and unknown. Hence, we examined the efficacy of CRT measured by heart failure (HF)-related hospitalizations and all-cause mortality among immigrants and non-immigrants. METHODS AND RESULTS: All immigrants and non-immigrants who underwent first-time CRT implantation in Denmark (2000-2017) were identified from nationwide registries and followed for up to 5 years. Differences in HF related hospitalizations and all-cause mortality were evaluated by Cox regression analyses. From 2000 to 2017, 369 of 10 741 (3.4%) immigrants compared with 7855 of 223 509 (3.5%) non-immigrants with a HF diagnosis underwent CRT implantation. The origins of the immigrants were Europe (61.2%), Middle East (20.1%), Asia-Pacific (11.9%), Africa (3.5%), and America (3.3%). We found similar high uptake of HF guideline-directed pharmacotherapy before and after CRT and a consistent reduction in HF-related hospitalizations the year before vs. the year after CRT (61% vs. 39% for immigrants and 57% vs. 35% for non-immigrants). No overall difference in 5-year mortality among immigrants and non-immigrants was seen after CRT [24.1% and 25.8%, respectively, P-value = 0.50, hazard ratio (HR) = 1.2, 95% confidence interval (CI): 0.8-1.7]. However, immigrants of Middle Eastern origin had a higher mortality rate (HR = 2.2, 95% CI: 1.2-4.1) compared with non-immigrants. Cardiovascular causes were responsible for the majority of deaths irrespective of immigration status (56.7% and 63.9%, respectively). CONCLUSION: No overall differences in efficacy of CRT in improving outcomes between immigrants and non-immigrants were identified. Although numbers were low, a higher mortality rate among immigrants of Middle Eastern origin was identified compared with non-immigrants.
Databáze: OpenAIRE
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