scholarly journals Effect of Race and Ethnicity on In-Hospital Mortality in Patients with COVID-2019

2021 ◽  
Vol 31 (3) ◽  
pp. 389-398
Author(s):  
Adnan I. Qureshi ◽  
William I. Baskett ◽  
Wei Huang ◽  
Daniel Shyu ◽  
Danny Myers ◽  
...  
Keyword(s):  
Palliative Care ◽  
African American ◽  
Hospital Mortality ◽  
Race And Ethnicity ◽  
Pacific Islander ◽  
Sociodemographic Factors ◽  
Secondary Outcome ◽  
Do Not Resuscitate ◽  
Short Term ◽  
White Patients

Objective: To identify differences in short-term outcomes of patients with coronavirus disease 2019 (COVID-19) according to various racial/ethnic groups.Design: Analysis of Cerner de-identified COVID-19 dataset.Setting: A total of 62 health care facilities.Participants: The cohort included 49,277 adult COVID-19 patients who were hospitalized from December 1, 2019 to November 13, 2020.Methods: We compared patients’ age, gender, individual components of Charl­son and Elixhauser comorbidities, medical complications, use of do-not-resuscitate, use of palliative care, and socioeconomic status between various racial and/or ethnic groups. We further compared the rates of in-hos­pital mortality and non-routine discharges between various racial and/or ethnic groups.Main Outcome Measures: The primary outcome of interest was in-hospital mortali­ty. The secondary outcome was non-routine discharge (discharge to destinations other than home, such as short-term hospitals or other facilities including intermediate care and skilled nursing homes).Results: Compared with White patients, in-hospital mortality was significantly higher among African American (OR 1.5; 95%CI:1.3-1.6, P<.001), Hispanic (OR1.4; 95%CI:1.3-1.6, P<.001), and Asian or Pacific Islander (OR 1.5; 95%CI: 1.1-1.9, P=.002) patients after adjustment for age and gender, Elixhauser comorbidities, do-not-resuscitate status, palliative care use, and socioeconomic status.Conclusions: Our study found that, among hospitalized patients with COVID-2019, African American, Hispanic, and Asian or Pacific Islander patients had increased mortality compared with White patients after adjusting for sociodemographic factors, comorbidities, and do-not-resuscitate/pallia­tive care status. Our findings add additional perspective to other recent studies. Ethn Dis. 2021;31(3):389-398; doi:10.18865/ed.31.3.389

Racial/ethnic disparities in hospital utilization in intracerebral hemorrhage

2019 ◽  
Vol 14 (7) ◽  
pp. 686-695 ◽  
Author(s):  
Salvador Cruz-Flores ◽  
Gustavo J Rodriguez ◽  
Mohammad Rauf A Chaudhry ◽  
Ihtesham A Qureshi ◽  
Mohtashim A Qureshi ◽  
...  
Keyword(s):  
United States ◽  
Palliative Care ◽  
Intracerebral Hemorrhage ◽  
Hospital Mortality ◽  
Pacific Islander ◽  
The United States ◽  
Hospital Utilization ◽  
Hospital Charges ◽  
Do Not Resuscitate ◽  
Vp Shunt

Background and purpose There is evidence that racial and ethnic differences among intracerebral hemorrhage (ICH) patients exist. We sought to establish the occurrence of disparities in hospital utilization in the United States. Methods We identified ICH patients from United States Nationwide Inpatient Sample database for years 2006–2014 using codes (DX1 = 431, 432.0) from the International Classification of Diseases, 9th edition. We compared five race/ethnic categories: White, Black, Hispanic, Asian or Pacific Islander, and Others ( Native American and other) with regard to demographics, comorbidities, disease severity, in-hospital complications, in-hospital procedures, length of stay (LOS), total hospital charges, in-hospital mortality, palliative care, (PC) and do not resuscitate (DNR). We categorized procedures as lifesaving (i.e. ventriculostomy, craniotomy, craniectomy, and ventriculoperitoneal (VP) shunt), life sustaining (i.e. mechanical ventilation, tracheostomy, transfusions, and gastrostomy). White race/ethnicity was set as the reference group. Results Out of 710,293 hospitalized patients with ICH 470,539 (66.2%), 114,821 (16.2%), 66,451 (9.3%), 30,297 (4.3%) and 28,185 (3.9%) were White, Black, Hispanic, Asian or Pacific Islander, and Others, respectively. Minorities (Black, Hispanic, Asian or Pacific Islander, and Others) had a higher rate of in-hospital complications, in-hospital procedures, mean LOS, and hospital charges compared to Whites. In contrast, Whites had a higher rate of in-hospital mortality, PC, and DNR. In multivariable analysis, all minorities had higher rate of MV, tracheostomy, transfusions, and gastrostomy compared to Whites, while Hispanics had higher rate of craniectomy and VP shunt; and Asian or Pacific Islander and Others had higher rate of craniectomy. Whites had a higher rate of in-hospital mortality, palliative care, and DNR compared to minorities. In mediation analysis, in-hospital mortality for whites remained high after adjusting with PC and DNR. Conclusion Minorities had greater utilization of lifesaving and life sustaining procedures, and longer LOS. Whites had greater utilization of palliative care, hospice, and higher in-hospital mortality. These results may reflect differences in culture or access to care and deserve further study.

Ethnicity, race, and advance directives in an inpatient palliative care consultation service

2012 ◽  
Vol 11 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Glenn B. Zaide ◽  
Renee Pekmezaris ◽  
Christian N. Nouryan ◽  
Tanveer P. Mir ◽  
Cristina P. Sison ◽  
...  
Keyword(s):  
Palliative Care ◽  
African Americans ◽  
Advance Directives ◽  
Advance Directive ◽  
Race And Ethnicity ◽  
Primary Diagnosis ◽  
Do Not Resuscitate ◽  
Palliative Care Consultation ◽  
Care Consultation ◽  
The Impact

AbstractObjective:Although race and ethnic background are known to be important factors in the completion of advance directives, there is a dearth of literature specifically investigating the effect of race and ethnicity on advance directive completion rate after palliative care consultation (PCC).Method:A chart review of all patients seen by the PCC service in an academic hospital over a 9-month period was performed. Data were compiled using gender, race, ethnicity, religion, and primary diagnosis. For this study, advance directives were defined as: “Do Not Resuscitate” (DNR) and/or “Do Not Intubate” (DNI).Results:Of the 400 medical records reviewed, 57% of patients were female and 71.3% documented their religion as Christian. The most common documented diagnosis was cancer (39.5%). Forty-seven percent reported their race as white. White patients completed more advance directives than did nonwhite patients both before (25.67% vs. 12.68%) and after (59.36% vs. 40.84%) PCC. There was a significantly higher proportion of whites who signed an advance directive after a PCC than of nonwhites (p = 0.021); of the 139 whites who did not have an advance directive at admission, 63 signed an advance directive after a PCC compared with 186/60 nonwhites (45% vs. 32%, respectively, p = 0.021). Further analysis revealed that African Americans differed from whites in the likelihood of advance directive execution rates pre-PCC, but not post-PCC.Significance of results:This study demonstrates the impact of a PCC on the completion of advance directives, on both whites and nonwhites. The PCC Intervention significantly reduced differences between whites and African Americans in completing advance directives, which have been consistently documented in the end-of-life literature.

scholarly journals Evaluating the associations of race, ethnicity, and food allergens in the development of childhood asthma: Re-analysis of publicly available retrospective cross-sectional cohort data

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1209
Author(s):  
Musheer Abdalhuk ◽  
Angel Jordan ◽  
Roghan Wagimin ◽  
Charles Stamitoles ◽  
Shandra Bellinger ◽  
...  
Keyword(s):  
Race And Ethnicity ◽  
Childhood Asthma ◽  
Pacific Islander ◽  
Sociodemographic Factors ◽  
Asthma Prevalence ◽  
Food Allergens ◽  
Cross Sectional ◽  
Asian Pacific Islander ◽  
Before And After ◽  
Asian Pacific

Asthma is among the most prevalent chronic diseases affecting children worldwide. Sociodemographic factors, such as race and ethnicity, as well as food allergens and their association with asthma, have been extensively studied in an individual manner. Less is known about how food allergens can influence the effect of sociodemographic factors on childhood asthma prevalence. In this study, we re-analyzed a publicly available retrospective cross-sectional cohort dataset of childhood asthma. Multiple logistic regression of asthma by race and ethnicity, before and after adjustment by the most prevalent allergens, was implemented to the dataset. Hispanic individuals showed a higher odds risk (ORs; 1.30, CI 1.26 – 1.35) of asthma than Non-Hispanic individuals (0.24, CI 0.23 – 0.25), but after adjustment by most frequent food allergens reactivities (shellfish, peanut, and milk), the asthma odd risks were comparable (Hispanic, 3.62 [CI 3.49 – 3.76]; Non-Hispanic, 3.51 [3.47 – 3.52]). When considering race, Black individuals (1.90, CI 1.87 – 1.94) had higher ORs of asthma than White individuals (0.21, CI 0.20 – 0.22), Asian/Pacific Islander individuals (1.00, CI 0.95 – 1.05), and Other/Unknown races (1.14, CI 1.11 – 1.27). Although the ORs increased by three to four times for all races after adjusting for the most frequent food allergen reactivities, the same pattern of childhood asthma remained when considering races (in this order, Black, Other/Unknown, Asian/Pacific Islander, and White). In the dataset evaluated in this study, food allergens modified the association of race and ethnicity with the development of asthma. Therefore, public health interventions that gear towards the incidence of childhood asthma should contemplate the interplay and differences in nutrition among races and ethnicities.

Abstract 14: Disparities in Cardiovascular Disease Outcomes Among Pregnant Females

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Mohamed M Gad ◽  
Islam Y Elgendy ◽  
Ahmed M Mahmoud ◽  
Anas M Saad ◽  
Hani Jneid ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Embolism ◽  
African American ◽  
African Americans ◽  
Hospital Mortality ◽  
Pregnant Women ◽  
Racial Disparities ◽  
The United States ◽  
Median Income ◽  
White Patients

Introduction: The incidence of cardiovascular (CV) disease among pregnant women is rising in the United States (US). Data on racial disparities for the major CV events during pregnancy are limited. Methods: Pregnant women hospitalized from January 2007 to September 2015 were identified in the Nationwide Inpatient Sample. Outcomes of interest were mortality, myocardial infarction (MI), stroke, and pulmonary embolism (PE). Multivariate regression analysis was used for Odds Ratio (OR) and 95% Confidence Interval (CI). Results: Among 37,524,315 pregnant women, 17,159,400 (45.7%) were White, 4,921,574 (13.1%) were African American, and 7,111,216 (19.0%) were Hispanic. Following 2010, trends of mortality and stroke declinedsignificantly in African Americans, however, were stable in Whites (Figure). In-hospital mortality was 13.52 per 100,000 hospitalizations. The incidence of in-hospital mortality was highest among AfricanAmericans followed by White, then Hispanic patients; 29.63, 10.61, and 9.73 per 100,000 hospitalizations, respectively. The majority of African Americans (61.9%) were insured by Medicaid while the majority of White patients had private insurance (61.9%). Most of African American patients were below-median income (70.54%) while nearly half of the White patients were above the median income (47%). Compared to Whites, African Americans had the highest mortality with OR of 2.79, 95% CI (2.61-2.99), myocardial infarction with OR of 2.178, 95% CI (2.01-2.36), stroke with OR of 2.04, 95% CI (1.96-2.13), and pulmonary embolism with OR of 1.95, 95% CI (1.82-2.08). Conclusions: Significant racial disparities exist in the major CV events among pregnant women. Further efforts are needed to minimize these differences.

Nation-wide trends in mortality of patients with ocular and orbit melanoma: 2000 to 2014.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e21061-e21061
Author(s):  
William Forehand ◽  
Swathi Gopishetty ◽  
Ashkan Shahbandi ◽  
Achuta Kumar Guddati
Keyword(s):  
African American ◽  
American Indian ◽  
Pacific Islander ◽  
Ocular Melanoma ◽  
Alaskan Native ◽  
The Past ◽  
Asian Pacific Islander ◽  
American Black ◽  
Asian Pacific ◽  
White Patients

e21061 Background: Ocular and orbit melanoma is a rare subtype of melanoma for which outcomes have not been adequately reported. In this study we he have analyzed the incidence-based mortality trends of ocular and orbit melanoma over a 15 year period. Most ocular melanomas originate from the uvea and to a lesser extent from the conjunctiva. Primary orbital melanoma is exceedingly rare. The incidence of ocular melanoma has been stable for the past few decades but incidence-based mortality has not been studied over the past 15 years. Methods: The Surveillance, Epidemiology, and End Results (SEER) Database was utilized to query the incidence-based mortality for all patients diagnosed with ocular and orbit melanoma for the years 2000 to 2014. The results were grouped by gender and race (Caucasian/White, African American/Black, American Indian/Alaskan native and Asian/Pacific Islander). Paired T-test was used to determine statistically significance difference between various subgroups (p < 0.05). Results: Incidence-based mortality has been the highest in Caucasian/White patients from 2000 to 2014 followed by African American/Black and Asian/Pacific Islander patients. American Indian/Alaskan native patients appear to have the least mortality. There was a statistically significant difference (p < 0.05) in mortality between Caucasian/White patients from 2000 to 2014 followed by African American/Black and Asian/Pacific Islander patients. The sample size for African American/Black and American Indian/Alaskan native patients was too low for discerning a meaningful trend in mortality. Overall it appears that Caucasian males and females have a far higher and worsening incidence-based mortality compared to other races. Conclusions: Ocular melanoma and orbit melanoma are rare entities which are predominantly seen in Caucasian/White patients. This study shows that the incidence-based-mortality has been worsening for these patients in the past two decades. These entities have poor prognosis and have not been studied extensively in immunotherapy trials. This study highlights the need for new clinical trials to help improve the mortality rates.

scholarly journals Racial and Ethnic Disparities in Management and Outcomes of Cardiac Arrest Complicating Acute Myocardial Infarction

2021 ◽  
Author(s):  
Anna V. Subramaniam ◽  
Sri Harsha Patlolla ◽  
Wisit Cheungpasitporn ◽  
Pranathi R. Sundaragiri ◽  
P. Elliott Miller ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Palliative Care ◽  
Hospital Mortality ◽  
Coronary Intervention ◽  
Do Not Resuscitate ◽  
Palliative Care Consultation ◽  
Black Patients ◽  
Percutaneous Coronary ◽  
Care Consultation

Background The role of race and ethnicity in the outcomes of cardiac arrest (CA) complicating acute myocardial infarction (AMI) is incompletely understood. Methods and Results This was a retrospective cohort study of adult admissions with AMI‐CA from the National Inpatient Sample (2012–2017). Self‐reported race/ethnicity was classified as White, Black, and others (Hispanic, Asian or Pacific Islander, Native American, Other). Outcomes of interest included in‐hospital mortality, coronary angiography, percutaneous coronary intervention, palliative care consultation, do‐not‐resuscitate status use, hospitalization costs, hospital length of stay, and discharge disposition. Of the 3.5 million admissions with AMI, CA was noted in 182 750 (5.2%), with White, Black, and other races/ethnicities constituting 74.8%, 10.7%, and 14.5%, respectively. Black patients admitted with AMI‐CA were more likely to be female, with more comorbidities, higher rates of non–ST‐segment–elevation myocardial infarction, and higher neurological and renal failure. Admissions of patients of Black and other races/ethnicities underwent coronary angiography (61.9% versus 70.2% versus 73.1%) and percutaneous coronary intervention (44.6% versus 53.0% versus 58.1%) less frequently compared to patients of white race ( p <0.001). Admissions of patients with AMI‐CA had significantly higher unadjusted mortality (47.4% and 47.4%) as compared with White patients admitted (40.9%). In adjusted analyses, Black race was associated with lower in‐hospital mortality (odds ratio [OR], 0.95; 95% CI, 0.91–0.99; P =0.007) whereas other races had higher in‐hospital mortality (OR, 1.11; 95% CI, 1.08–1.15; P <0.001) compared with White race. Admissions of Black patients with AMI‐CA had longer length of hospital stay, higher rates of palliative care consultation, less frequent do‐not‐resuscitate status use, and fewer discharges to home (all P <0.001). Conclusions Racial and ethnic minorities received less frequent guideline‐directed procedures and had higher in‐hospital mortality and worse outcomes in AMI‐CA.

scholarly journals Mortality and risk factors among US Black, Hispanic, and White patients with COVID-19

2020 ◽  
Author(s):  
Tomi Jun ◽  
Sharon Nirenberg ◽  
Patricia Kovatch ◽  
Kuan-lin Huang
Keyword(s):  
Risk Factors ◽  
New York ◽  
Hospital Mortality ◽  
Health System ◽  
Race And Ethnicity ◽  
Interleukin 1 ◽  
The United States ◽  
Black Race ◽  
Hispanic Patients ◽  
White Patients

Background: Little is known about risk factors for COVID-19 outcomes, particularly across diverse racial and ethnic populations in the United States. Methods: In this prospective cohort study, we followed 3,086 COVID-19 patients hospitalized on or before April 13, 2020 within an academic health system in New York (The Mount Sinai Health System) until June 2, 2020. Multivariable logistic regression was used to evaluate demographic, clinical, and laboratory factors as independent predictors of in-hospital mortality. The analysis was stratified by self-reported race and ethnicity. Findings: A total of 3,086 COVID-19 patients were hospitalized, of whom 680 were excluded (78 due to missing race or ethnicity data, 144 were Asian, and 458 were of other unspecified race/ethnicity). Of the 2,406 patients included, 892 (37.1%) were Hispanic, 825 (34.3%) were black, and 689 (28.6%) were white. Black and Hispanic patients were younger than White patients (median age 67 and 63 vs. 73, p<0.001 for both), and they had different comorbidity profiles. Older age and baseline hypoxia were associated with increased mortality across all races. There were suggestive but non-significant interactions between Black race and diabetes (p=0.09), and obesity (p=0.10). Among inflammatory markers associated with COVID-19 mortality, there was a significant interaction between Black race and interleukin-1-beta (p=0.04), and a suggestive interactions between Hispanic ethnicity and procalcitonin (p=0.07) and interleukin-8 (p=0.09). Interpretation: In this large, racially and ethnically diverse cohort of COVID-19 patients in New York City, we identified similarities and important differences across racial and ethnic groups in risk factors for in-hospital mortality.

scholarly journals Vitamin C for ≥ 5 days is associated with decreased hospital mortality in sepsis subgroups: a nationwide cohort study

Critical Care ◽  
2022 ◽  
Vol 26 (1) ◽  
Author(s):  
Sun-Young Jung ◽  
Min-Taek Lee ◽  
Moon Seong Baek ◽  
Won-Young Kim
Keyword(s):  
Vitamin C ◽  
Hospital Mortality ◽  
Primary Outcome ◽  
Population Based ◽  
Secondary Outcome ◽  
Short Term ◽  
Population Based Study ◽  
Korean National Health Insurance ◽  
The Mean ◽  
Intravenous Vitamin

Abstract Background Previous randomized trials of vitamin C, hydrocortisone, and thiamine on sepsis were limited by short-term vitamin C administration, heterogeneous populations, and the failure to evaluate each component’s effect. The purpose of this study was to determine whether vitamin C alone for ≥ 5 days or in combination with corticosteroids and/or thiamine was associated with decreased mortality across the sepsis population and subpopulation. Methods Nationwide population-based study conducted using the Korean National Health Insurance Service database. A total of 384,282 adult patients with sepsis who were admitted to the intensive care unit were enrolled from January 2017 to December 2019. The primary outcome was hospital mortality, while the key secondary outcome was 90-day mortality. Results The mean [standard deviation] age was 69.0 [15.4] years; 57% were male; and 36,327 (9%) and 347,955 did and did not receive vitamin C, respectively. After propensity score matching, each group involved 36,327 patients. The hospital mortality was lower by − 0.9% in the treatment group (17.1% vs 18.0%; 95% confidence interval, − 1.3 to − 0.5%; p < 0.001), a significant but extremely small difference. However, mortality decreased greater in patients who received vitamin C for ≥ 5 days (vs 1–2 or 3–4 days) (15.8% vs 18.8% vs 18.3%; p < 0.001). Further, vitamin C was associated with a lower hospital mortality in patients with older age, multiple comorbidities, pneumonia, genitourinary infection, septic shock, and mechanical ventilation. Consistent findings were found for 90-day mortality. Moreover, vitamin C alone or in combination with thiamine was significantly associated with decreased hospital mortality. Conclusions Intravenous vitamin C of ≥ 5 days was significantly associated with decreased hospital and 90-day mortality in sepsis patients. Vitamin C combined with corticosteroids and/or thiamine in specific sepsis subgroups warrants further study.

Abstract WP322: The Use of a Dysphagia-gastrostomy-palliative Care Algorithm Increases Involvement of the Palliative Care Service

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Christa San Luis ◽  
Sherry Stephens-Gibson ◽  
Jian Chen ◽  
Manasa Gunturu
Keyword(s):  
Palliative Care ◽  
Ischemic Stroke ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Task Force ◽  
Medical Center ◽  
Care Service ◽  
Palliative Care Service ◽  
Secondary Outcome ◽  
Artificial Nutrition

Dysphagia is one of the most common reasons for a gastrostomy tube (GT) placement as a means of chronic nutrition as the patient transitions to rehabilitation. Discussion regarding artificial nutrition is one of the reasons palliative care service becomes involved in the care of an ischemic stroke patient. Recent recommendations state that palliative care involvement should be promoted as part of patient- and family- centered care. To provide timely palliative care involvement, dysphagia evaluations by speech and language pathologists (SLPs), GT placement in the in-patient setting, a Dysphagia-Gastrostomy-Palliative care (DG-Pal) multidisciplinary algorithm was created. Hypothesis: The authors hypothesize that the use of the DG-Pal algorithm will increase palliative care involvement, shorten the time to SLP dysphagia evaluation, and the time for GT placement without increase in in-patient mortality. Methods: The DG-Pal algorithm was created by a Stroke Gastrostomy Task Force of the University of Mississippi Medical Center Stroke. The patients admitted with acute ischemic strokes were grouped into “Before DG-Pal (June 2015) versus After DG-Pal (January 2016)”. Primary outcome included palliative care involvement and timing. Secondary outcome include time to first SLP dysphagia evaluation, GT placement, and in-hospital mortality rate. Results: A total of 78 patients were included for analysis. There were 45 (58%) patients included in the “before DG-Pal” cohort. Palliative care involvement was significantly higher in the “after DG-Pal” cohort (36% vs 4.5%, p=.001). The timing of palliative care involvement and time to first SLP dysphagia evaluation were similar in both groups. GTs were placed only among the “after DG-Pal” cohort (3, [9%]). In-hospital mortality rate was comparable between “before DG-Pal” and “after DG-Pal” groups respectively (2.3% vs 6.1%). Conclusions: This is the first report of the use of a multi-disciplinary Dysphagia-Gastrostomy-Palliative care (DG-Pal) algorithm to improve palliative care involvement and the coordination of care for ischemic stroke patients. Further prospective studies are needed to further analyze the effect on patient and family outcomes.

P6192Effects of evolocumab on LDL-C by race and ethnicity: an analysis of double-blind and open-label extension studies

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C J Rodriguez ◽  
M L Daviglus ◽  
J A G Lopez ◽  
Y Wu ◽  
M L Monsalvo ◽  
...  
Keyword(s):  
African American ◽  
Standard Deviation ◽  
Sample Size ◽  
Race And Ethnicity ◽  
Atherosclerotic Cardiovascular Disease ◽  
Statin Intolerance ◽  
Double Blind ◽  
Percent Change ◽  
Asian Patients ◽  
White Patients

Abstract Background/Introduction Cardiovascular risk factors and clinical outcomes of atherosclerotic cardiovascular disease (ASCVD) vary amongst racial and ethnic groups. Purpose To examine the effects of evolocumab on low-density lipoprotein cholesterol (LDL-C) levels and achievement of LDL-C target goals by race or ethnicity. Methods Data from global phase 2 and 3 studies with at least 12 weeks of treatment with approved evolocumab doses vs. placebo or ezetimibe were included in this analysis (n=4375). Results were analysed by patient characteristics (statin intolerance, type 2 diabetes, heterozygous familial hypercholesterolaemia, and hypercholesterolaemia/mixed dyslipidaemia), self-identified race (White, Black/African American, and Asian), and self-identified ethnicity (Hispanic/Latino). Key outcomes included percent change in LDL-C, achievement of LDL-C <1.8 mmol/L (<70 mg/dL), and LDL-C achievement of at least 50% reduction. Results After 12-week evolocumab treatment, mean percent change in LDL-C from baseline ranged from approximately −52% to −59% for white patients to −49% to −67% for non-white patients, across all groups with adequate sample size (n>20) (Table). LDL-C <1.8 mmol/L was achieved in 43–84% of white patients and 62–94% of non-white patients receiving evolocumab (n>20). Similarly, 63–78% of white patients and 58–86% of non-white patients achieved at least a 50% reduction in LDL-C. The magnitude of treatment effect on mean percent change in LDL-C differed significantly only between white and non-white patients with diabetes (interaction p-values of treatment by race for evolocumab every 2 weeks p<0.001; once monthly p=0.007). This was driven by a greater reduction in Asian patients. Mean (standard deviation) percent change in LDL-C levels from baseline, % Achievement of LDL-C <1.8 mmol/L (70 mg/dL)/LDL-C achievement of at least 50% reduction, % Population White Non-White Non-Hispanic Black or African American Asian Hispanic/Latino* White Non-White Non-Hispanic Black or African American Asian Hispanic/Latino* Statin-Intolerant† −55.4 (14.8) −46.3 (20.9) −46.0 (13.4) −49.0 (29.3) −54.6 (12.3) 42.9 / 68.6 26.7 / 60.0 14.3 / 42.9 50.0 / 83.3 0 / 66.7 n=210 n=15 n=7 n=6 n=3 Diabetes‡ −51.5 (25.6) −66.5 (21.2) −50.4 (22.2) −69.6 (20.2) −59.7 (20.5) 82.3 / 63.0 93.9 / 82.0 90.0 / 62.5 95.1 / 86.6 89.2 / 75.3 n=440 n=395 n=40 n=305 n=158 HeFH§ −57.3 (19.7) −64.1 (12.0) −73.8 (4.1) −60.5 (12.8) −35.8§§ 66.1 / 73.7 61.5 / 84.6 100 / 100 53.3 / 80.0 0 / 0 n=236 n=26 n=3 n=15 n=1 Hyper-cholesterolaemia/ −58.8 (19.2) −65.5 (17.0) −51.2 (19.4) −69.4 (13.9) −54.6 (20.3) 83.3 / 77.6 89.7 / 86.0 74.4 / 60.5 94.7 / 93.5 79.1 / 69.2   Mixed Dyslipidaemia¶ n=1399 n=437 n=86 n=339 n=91 Hyper-cholesterolaemia/ −59.4 (17.1) −58.4 (16.9) −52.8 (19.4) −65.8 (10.3) −56.7 (22.1) 80.2 / 78.5 85.7 / 75.7 82.4 / 67.6 96.7 / 93.3 77.3 / 68.2   Mixed Dyslipidaemia†† n=605 n=70 n=34 n=30 n=44 1-Year Study‡‡ −52.1 (27.7) −48.6 (29.2) −50.8 (22.0) −49.5 (29.4) −43.0 (43.1) 84.4 / 67.4 73.6 / 57.5 74.5 / 59.6 76.5 / 58.8 82.1 / 60.7 n=436 n=106 n=47 n=34 n=28 †GAUSS-1, -2 studies; ‡BANTING and BERSON studies; §RUTHERFORD-1, -2 studies; ¶Placebo comparator: MENDEL-1, -2, LAPLACE-TIMI-57, LAPLACE-2 and YUKAWA-1, -2 studies; ††Ezetimibe comparator: MENDEL-2 and LAPLACE-2 atorvastatin cohorts; ‡‡DESCARTES; §§Standard deviation could not be calculated due to insufficient sample size. *A total of 22 patients receiving evolocumab self-identified as Hispanic Black. Conclusion Reduction in LDL-C levels with evolocumab treatment was similar across race and ethnicity, apart from the diabetes population where Asian patients had a greater reduction in LDL-C. Acknowledgement/Funding Amgen Inc.

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