Abstract

Background The clinical characteristics of heart failure differ significantly between African American patients and white patients, apparently as a result of differences in the pathobiology of the condition in the races. We investigated the hypothesis that race also influences the survival of patients with heart failure. Methods Data from the University of North Carolina Heart Failure Database were analyzed for 853 patients (44% African American, 32% women) who had symptomatic heart failure (New York Heart Association class 2.8 ± 0.02 [mean ± SEM]) with a reduced left ventricular ejection fraction of 26% ± 0.5% and a body mass index of 27 ± 0.2. Data on vital status were available in 96.4% of these patients, with a mean length of follow-up of 3.8 ± 0.1 years. Results An unadjusted univariate proportional-hazards analysis suggested similar survival rates between African American patients and white patients in the study population (relative risk, 0.90; 95% CI, 0.73-1.10; P = .293). Adjusted analysis, taking into account the characteristics shown to be of prognostic importance, demonstrated no difference in survival rate between African American patients and white patients (relative risk,1.12; 95% CI, 0.89-1.42; P = .336). The adjusted relative risk of all-cause mortality in the respective races among patients with heart failure caused by ischemic heart disease was 1.21 (95% CI, 0.80-1.84; P = .367). Conclusion African American and white patients with symptomatic heart failure had similar survival rates in our database.

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