Abstract Sun603: Racial/Ethnic Disparities in Post-Arrest Cardiac Procedures for Out-of-Hospital Cardiac Arrest

Abstract

Effective post-arrest care interventions are important components of the out-of-hospital cardiac arrest (OHCA) chain of survival. These can include echocardiography to identify potential cardiac etiologies and guide management. Additionally, left heart catheterization (LHC) and percutaneous coronary interventions (PCI) can identify coronary vessel disease and address culprit lesions. Finally, ventricular assist devices (VAD) can assist with systemic perfusion and management of cardiogenic shock. While studies have demonstrated race/ethnicity variation in other links of the chain of survival, little is known about patient race/ethnicity-based disparities in these post-arrest cardiac procedures. We retrospectively studied OHCAs between 2013-2024 from the Trinetx research database. Trinetx is a Real-World Database of EHR data with > 100 million patients across numerous hospitals primarily in the US. We defined OHCA as patients who had an ED visit with a diagnosis of cardiac arrest. We included patients who survived to hospital admission. We defined race/ethnicity groups as non-Hispanic White (White, reference), non-Hispanic Black (Black), and Hispanic/Latino (Hispanic). Using logistic regression, we compared rates of cardiac interventions between race/ethnicity groups; 1) echocardiography; 2) LHC; 3) PCI; and 4) VAD placement. A total of 67,984 cardiac arrest cases met inclusion criteria: 44,685 (65.7%) were White patients, 17,515 (25.8%) were Black patients, and 5,784 (12.9%) were Hispanic/Latino patients. No significant difference was identified for post-arrest echocardiography across race/ethnicity. However, compared with White patients (LHC – 12.8%, PCI – 6.5%, VAD – 3.0%), Black patients had lower odds of receiving LHC (6.8%, OR 0.7 [0.6-0.7]), PCI (2.5%, OR 0.4 [0.3-0.4]), and VAD placement (1.6%, OR 0.5 [0.5-0.6]). Hispanic/Latino patients were also less likely to receive LHC (8.8%, OR 0.7 [0.6-0.7]) and PCI (3.7%, OR 0.6, [0.5-0.6]). VAD placement (2.9%) was similar for Hispanic/Latino patients. Our analysis of a large multicenter database indicates racial/ethnic disparities in the availability of post-arrest cardiac treatments, including LHC, PCI, and VAD placement. Further research is needed to identify potential causes for these disparities and generate potential strategies to mitigate them.