Race and Beta‐Blocker Survival Benefit in Patients With Heart Failure: An Investigation of Self‐Reported Race and Proportion of African Genetic Ancestry

BackgroundIt remains unclear whether beta‐blockade is similarly effective in black patients with heart failure and reduced ejection fraction as in white patients, but self‐reported race is a complex social construct with both biological and environmental components. The objective of this study was t...

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Autores principales:	Jasmine A. Luzum, Edward Peterson, Jia Li, Ruicong She, Hongsheng Gui, Bin Liu, John A. Spertus, Yigal M. Pinto, L. Keoki Williams, Hani N. Sabbah, David E. Lanfear
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2018
Materias:	ancestry beta‐blocker disparity genetics genomics heart failure Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/6c4d5fa512864fdcaafde877e8c202e0
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spelling	oai:doaj.org-article:6c4d5fa512864fdcaafde877e8c202e02021-11-12T17:02:01ZRace and Beta‐Blocker Survival Benefit in Patients With Heart Failure: An Investigation of Self‐Reported Race and Proportion of African Genetic Ancestry10.1161/JAHA.117.0079562047-9980https://doaj.org/article/6c4d5fa512864fdcaafde877e8c202e02018-05-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.117.007956https://doaj.org/toc/2047-9980BackgroundIt remains unclear whether beta‐blockade is similarly effective in black patients with heart failure and reduced ejection fraction as in white patients, but self‐reported race is a complex social construct with both biological and environmental components. The objective of this study was to compare the reduction in mortality associated with beta‐blocker exposure in heart failure and reduced ejection fraction patients by both self‐reported race and by proportion African genetic ancestry. Methods and ResultsInsured patients with heart failure and reduced ejection fraction (n=1122) were included in a prospective registry at Henry Ford Health System. This included 575 self‐reported blacks (129 deaths, 22%) and 547 self‐reported whites (126 deaths, 23%) followed for a median 3.0 years. Beta‐blocker exposure (BBexp) was calculated from pharmacy claims, and the proportion of African genetic ancestry was determined from genome‐wide array data. Time‐dependent Cox proportional hazards regression was used to separately test the association of BBexp with all‐cause mortality by self‐reported race or by proportion of African genetic ancestry. Both sets of models were evaluated unadjusted and then adjusted for baseline risk factors and beta‐blocker propensity score. BBexp effect estimates were protective and of similar magnitude both by self‐reported race and by African genetic ancestry (adjusted hazard ratio=0.56 in blacks and adjusted hazard ratio=0.48 in whites). The tests for interactions with BBexp for both self‐reported race and for African genetic ancestry were not statistically significant in any model (P>0.1 for all). ConclusionsAmong black and white patients with heart failure and reduced ejection fraction, reduction in all‐cause mortality associated with BBexp was similar, regardless of self‐reported race or proportion African genetic ancestry.Jasmine A. LuzumEdward PetersonJia LiRuicong SheHongsheng GuiBin LiuJohn A. SpertusYigal M. PintoL. Keoki WilliamsHani N. SabbahDavid E. LanfearWileyarticleancestrybeta‐blockerdisparitygeneticsgenomicsheart failureDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 7, Iss 10 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	ancestry beta‐blocker disparity genetics genomics heart failure Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	ancestry beta‐blocker disparity genetics genomics heart failure Diseases of the circulatory (Cardiovascular) system RC666-701 Jasmine A. Luzum Edward Peterson Jia Li Ruicong She Hongsheng Gui Bin Liu John A. Spertus Yigal M. Pinto L. Keoki Williams Hani N. Sabbah David E. Lanfear Race and Beta‐Blocker Survival Benefit in Patients With Heart Failure: An Investigation of Self‐Reported Race and Proportion of African Genetic Ancestry
description	BackgroundIt remains unclear whether beta‐blockade is similarly effective in black patients with heart failure and reduced ejection fraction as in white patients, but self‐reported race is a complex social construct with both biological and environmental components. The objective of this study was to compare the reduction in mortality associated with beta‐blocker exposure in heart failure and reduced ejection fraction patients by both self‐reported race and by proportion African genetic ancestry. Methods and ResultsInsured patients with heart failure and reduced ejection fraction (n=1122) were included in a prospective registry at Henry Ford Health System. This included 575 self‐reported blacks (129 deaths, 22%) and 547 self‐reported whites (126 deaths, 23%) followed for a median 3.0 years. Beta‐blocker exposure (BBexp) was calculated from pharmacy claims, and the proportion of African genetic ancestry was determined from genome‐wide array data. Time‐dependent Cox proportional hazards regression was used to separately test the association of BBexp with all‐cause mortality by self‐reported race or by proportion of African genetic ancestry. Both sets of models were evaluated unadjusted and then adjusted for baseline risk factors and beta‐blocker propensity score. BBexp effect estimates were protective and of similar magnitude both by self‐reported race and by African genetic ancestry (adjusted hazard ratio=0.56 in blacks and adjusted hazard ratio=0.48 in whites). The tests for interactions with BBexp for both self‐reported race and for African genetic ancestry were not statistically significant in any model (P>0.1 for all). ConclusionsAmong black and white patients with heart failure and reduced ejection fraction, reduction in all‐cause mortality associated with BBexp was similar, regardless of self‐reported race or proportion African genetic ancestry.
format	article
author	Jasmine A. Luzum Edward Peterson Jia Li Ruicong She Hongsheng Gui Bin Liu John A. Spertus Yigal M. Pinto L. Keoki Williams Hani N. Sabbah David E. Lanfear
author_facet	Jasmine A. Luzum Edward Peterson Jia Li Ruicong She Hongsheng Gui Bin Liu John A. Spertus Yigal M. Pinto L. Keoki Williams Hani N. Sabbah David E. Lanfear
author_sort	Jasmine A. Luzum
title	Race and Beta‐Blocker Survival Benefit in Patients With Heart Failure: An Investigation of Self‐Reported Race and Proportion of African Genetic Ancestry
title_short	Race and Beta‐Blocker Survival Benefit in Patients With Heart Failure: An Investigation of Self‐Reported Race and Proportion of African Genetic Ancestry
title_full	Race and Beta‐Blocker Survival Benefit in Patients With Heart Failure: An Investigation of Self‐Reported Race and Proportion of African Genetic Ancestry
title_fullStr	Race and Beta‐Blocker Survival Benefit in Patients With Heart Failure: An Investigation of Self‐Reported Race and Proportion of African Genetic Ancestry
title_full_unstemmed	Race and Beta‐Blocker Survival Benefit in Patients With Heart Failure: An Investigation of Self‐Reported Race and Proportion of African Genetic Ancestry
title_sort	race and beta‐blocker survival benefit in patients with heart failure: an investigation of self‐reported race and proportion of african genetic ancestry
publisher	Wiley
publishDate	2018
url	https://doaj.org/article/6c4d5fa512864fdcaafde877e8c202e0
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Race and Beta‐Blocker Survival Benefit in Patients With Heart Failure: An Investigation of Self‐Reported Race and Proportion of African Genetic Ancestry

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