Abstract 12141: Echocardiographic Characteristics and Outcomes Between African American and Caucasians in Acute Pulmonary Embolism

Abstract

Introduction: Socio-economical differences and delayed medical care have been associated to a higher mortality in African American (AA) PE patients. Hypothesis: Peri-PE mortality is higher in AA than Caucasian (CC) patients in a single medical center. Methods: A 26 months retrospective review of AA and CC patients admitted with an acute PE. Results: A total of 303 AA and 343 CC were identified. African Americans were younger, had more females, diabetes, chronic kidney disease and smokers than CC. A history of recent surgery and trauma were more common in CC. (Table I) Both groups had similar clinical presentations, biomarkers, and radiologic characteristics (CTA); except for RV strain that was more common among AA. In the initial echocardiogram, LV function was similar in both groups, although, AA had more often an underfilled LV and an abnormal RV. (Table II) There was no difference in hospital mortality between AA (n=21[6.9%]) and CC (n=21[6.1%]), p=0.67. Among 107 (AA=54, CC=53) patients who received advanced therapies, the mortality was higher in AA (18.5% vs.3.8% p=0.01). In a logistic regression analysis, the risk of death was increased by age (OR 1.04; 95%CI 1.020-1.073) and the need of advanced therapies (OR 2.43; 95%CI 1.029-5.769). Although AA race (OR 1.77; 95%CI 0.862-3.647), BMI (OR 0.99; 95%CI 0.950-1.038), abnormal RV (OR 0.71; 95%CI 0.321-1.601) and abnormal LV function (OR 1.737; 95%CI 0.754-4.005) did not increase significantly the risk of death. Conclusion: Despite hemodynamic changes of the LV and RV appreciated in AA, there was no difference in overall mortality. The risk of death was increased by age and need for advanced therapies.