Primary Prevention Implantable Cardioverter-Defibrillators in Older Racial and Ethnic Minority XXXX .

@entity737 @entity1 @entity1479
BACKGROUND: -Racial and ethnic minorities are underrepresented in clinical trials of primary prevention @entity737 ( @entity737 ). This analysis investigates the association between primary prevention @entity737 and mortality among Medicare, racial/ethnic minority @entity1 . METHODS AND RESULTS: -Data from Get With The Guidelines-Heart Failure Registry and National Cardiovascular Data Registry's- @entity1479 Registry were used to perform an adjusted comparative effectiveness analysis of primary prevention @entity737 in Medicare, racial/ethnic minority @entity1 (non-white race or Hispanic ethnicity). Mortality data were obtained from the Medicare denominator file. The relationship of @entity1479 to survival was compared between minority and white non-Hispanic @entity1 . Our analysis included 852 minority @entity1 , 426 @entity1479 and 426 matched non- @entity1479 @entity1 , and 2,070 white non-Hispanic @entity1 (1,035 @entity1479 and 1,035 matched non- @entity1479 @entity1 ). Median follow-up was 3.1 years. Median age was 73 years, and median ejection fraction was 23%. Adjusted 3-year mortality rates for minority @entity1479 and non- @entity1479 @entity1 were 44.9% (95% CI: 44.2-45.7%) and 54.3% (95% CI: 53.4-55.1%), respectively (adjusted HR 0.79, CI: 0.63-0.98, p=0.034). White non-Hispanic @entity1 receiving an @entity1479 had lower adjusted 3-year mortality rates of 47.8% (95% CI: 47.3-48.3%) compared with 57.3% (95% CI: 56.8-57.9%) for those with no @entity1479 (adjusted HR 0.75, 95% CI 0.67-0.83, p<0.0001). There was no significant interaction between race/ethnicity and lower mortality risk with @entity1479 (p=0.70). CONCLUSIONS: -Primary prevention @entity737 are associated with lower mortality in non-white and Hispanic @entity1 , similar to that seen in white, non-Hispanic @entity1 . These data support a similar approach to @entity1479 @entity1 selection, regardless of race or ethnicity.
