Abstract 4370417: Racial Disparities in Major Adverse Cardiovascular Events Among Dementia Patients: A National Inpatient Sample Analysis (2016-2021)

Abstract

Background: Racial disparities in health outcomes are well-documented, yet their impact on major adverse cardiovascular and cerebrovascular events (MACCE) in patients with dementia remains insufficiently explored. This study examines racial differences in MACCE outcomes using data from the National Inpatient Sample (NIS) from 2016 to 2021. Methods: A retrospective cohort study was conducted utilizing NIS data, focusing on patients with dementia. Multivariate logistic regression was employed to adjust for potential confounders, analyzing the odds ratios for various MACCE outcomes across different racial groups. Results: The cohort included 9,195,501 White patients, 1,704,025 Black patients, 1,018,515 Hispanic patients, 327,035 Asian or Pacific Islander patients, 48,815 Native American patients, and 314,090 patients identified as Other. The mean ages were 80.5 years for White, 76.8 years for Black, 78.8 years for Hispanic, 81.1 years for Asian or Pacific Islander, 74.9 years for Native American, and 78.8 years for Other patients. Black patients exhibited higher odds of sudden cardiac death (OR 1.77, 95% CI 1.71–1.83, p < 0.0001) and were more likely to require dialysis (OR 2.75, 95% CI 2.61–2.91, p < 0.0001). Hispanic patients showed increased odds for sudden cardiac death (OR 1.40, 95% CI 1.34–1.47, p < 0.0001) and intracranial hemorrhage (OR 1.23, 95% CI 1.18–1.28, p < 0.0001). Asian or Pacific Islander patients had higher odds of sudden cardiac death (OR 1.65, 95% CI 1.54–1.77, p < 0.0001) and were less likely to experience heart block (OR 0.73, 95% CI 0.70–0.77, p < 0.0001). Notably, Native American patients had increased odds of requiring dialysis (OR 2.11, 95% CI 1.65–2.70, p < 0.0001) but did not show statistically significant differences for sudden cardiac death. Conclusion: This study highlights significant racial disparities in MACCE outcomes among dementia patients, with Black, Hispanic, and Asian or Pacific Islander patients demonstrating elevated risks for specific cardiovascular events compared to their White counterparts. These findings emphasize the need for targeted, culturally sensitive interventions to address the underlying factors contributing to these disparities in cardiovascular health among dementia patients. Future research should explore the mechanisms driving these differences to inform improved clinical practices and policies.