Impact of Initial Therapy on Readmissions in Minority Versus White Populations With Heart Failure

Background: Minority populations are often underrepresented in landmark trials for the management of heart failure with reduced ejection fraction (HFrEF). Major trials shaping the guidelines sometimes include as few as 5% black patients. Objective: The purpose of this pilot study was to evaluate the initiation of guideline-directed medical therapy (GDMT) for HFrEF on hospital discharge for minority vs white populations and its impact on all-cause 30-day readmission rates to identify areas for larger future research studies and opportunities for pharmacist intervention. Methods: A retrospective analysis was conducted on patients with HFrEF patients discharged over a 3-month period. The primary objective was to compare all-cause 30-day readmissions in minority vs white patients with HFrEF who were discharged on initial GDMT. Results: 300 patients were included in this study, with 188 patients in the minority group and 112 patients in the white group. The minority group was predominantly African American (92%). The primary endpoint demonstrated significantly higher 30-day all-cause readmissions in minority patients compared to white patients who received initial GDMT (20.5 vs 7.7%, P = .0144), despite similar rates of GDMT therapy between groups. Conclusion: Initial GDMT in minority patients may not reduce readmissions to the same extent seen in white patients. Special emphasis should be placed on evaluating minority patients with HFrEF for additional therapeutic interventions.