Abstract 15290: Race Stratified Prevalence and Predictors of Major Adverse Cardiac and Cerebrovascular Events in a Nationwide Multicentric Elderly Cohort Hospitalized With Heart Failure With Preserved Ejection Fraction From 2016-2019

Background: Race-stratified predictors of adverse cardiovascular and cerebral events in heart failure with preserved ejection fraction (HFpEF) have never been described before.

Methods: Using the National Inpatient Sample (2016-2019), we identified hospitalizations among elderly (>=65 years) HFpEF patients using relevant ICD-10 codes. Prevalence and trends of MACCE events were identified across sex and race from 2016 to 2019. Logistic regression analysis was used to estimate predictors of MACCE events across different racial groups. P<0.05 is considered significant.

Results: Of 6,134,669 total elderly HFpEF, 21% (n=780,615, males=13.5%) had MACCE events during hospitalization. MACCE events showed an uptrend from 2016-2019 across both males, females (13.5% vs.12.2%) and all racial groups with most difference seen in Native Americans (10.7 to 14.8%) and the least in Whites (12.0% to 12.9%) (Fig. 1). After stratification by race, hypertension had the highest odds of predicting a significant MACCE event in Hispanics (OR 2.06), while diabetes in whites (OR 1.05). Paradoxically, hyperlipidemia was associated with significant lower odds of MACCE in whites (OR 0.94), blacks (OR 0.94), and hispanics (OR 0.93), and smoking in whites (OR 0.78), blacks (OR 0.72), hispanics (OR 0.77), and asians (OR 0.77) (Table 1).

Conclusion: Cardiovascular events in elderly HFpEF patients increased over the past four years, with Native Americans being the most affected. Hypertension was found to be the strongest predictor in hispanics, whereas in whites it was diabetes. Future studies are warranted to investigate the predictors of MACCE in specific racial groups to curtail worse outcomes.