Abstract 12517: The Racial Disparity Among the Clinical Outcomes, and Management Utilization in Atrial Fibrillation Patients: A Meta Analysis

Abstract

Background: Although a higher burden of atrial fibrillation (AF) risk factors exists among the Black population, their prevalence of AF is less than White patients due to the under-diagnosis of minority groups and disparities in their management and outcomes. Objective: We aim to evaluate the disparities among the clinical outcomes post-AF, utilization of oral anticoagulants, and catheter ablation among Black and White race of patients. Methods: We systematically searched all electronic databases from inception until 27th May 2023. The primary outcome was all-cause mortality (ACM). Secondary outcomes include incidence of stroke, utilization of direct oral anticoagulants (DOAC), and catheter ablation. Results: A total of 11 studies with 1915540 patients were included in the final analysis (1771768 patients in the White group and 143772 patients of Black race). Pooled analysis of clinical outcomes shows that Black patients were having a higher risk of all-cause mortality (HR, 1.39(95%CI:1.09-1.75), P<0.01). Similarly compared with White patients, the odds of initiating DOAC therapy (OR, 0.85(95%CI: 0.80-0.91), P<0.001), and utilization of catheter ablation (OR, 0.69(95%CI: 0.52-0.86), P<0.001) were significantly lower in Black patients. Conclusion: Black patients with atrial fibrillation are found to be associated with higher mortality and lower utilization of management approaches like use of DOAC, and catheter ablation.