Disparities Among Immigrants and Native Patients in Denmark With New-Onset Heart Failure With Reduced Ejection...

Area of Science:

• Cardiology
• Public Health
• Health Disparities

Background:

• Significant variations in healthcare exist globally for heart failure (HF) patients.
• Understanding these disparities is crucial for equitable patient care.

Purpose of the Study:

• To compare immigrants by region of origin with native Danish patients presenting with new-onset heart failure with reduced ejection fraction (HFrEF).
• To analyze differences in demographics, comorbidities, and treatment outcomes.

Main Methods:

• Utilized data from the Danish Heart Failure Registry and administrative registries.
• Included medication, comorbidity, vital status, income, and education information.
• Co-primary outcomes: guideline-directed medical therapy (GDMT) uptitration and a composite of HF hospitalization and all-cause death.

Main Results:

• Included 55,918 patients; 5.2% were immigrants.
• Non-Western immigrants were younger (median 62 vs 72 years) with more diabetes and ischemic heart disease, and less atrial fibrillation.
• GDMT uptitration at 12 months was similar across groups; crude 3-year risk of HF hospitalization or death was lowest for non-Western immigrants but diminished in matched analyses.

Conclusions:

• Patients with HFrEF from non-Western regions in Denmark were younger with distinct comorbidity profiles compared to native Danes.
• GDMT uptitration rates were comparable, but initial adverse event rates were lower in immigrants, reducing to parity after age and sex matching.