Racial and ethnic differences in implantable cardioverter-defibrillator patient selection, management, and outcomes.
Racial and ethnic differences in implantable cardioverter-defibrillator patient selection, management, and outcomes.
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DOI：
10.1016/j.hroo.2022.09.003
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发表时间：
2022-12
期刊：
影响因子：
--
通讯作者：
Zeitler, Emily P.
中科院分区：
文献类型：
--
作者：
Kiernan, Katherine;Dodge, Shayne E.;Kwaku, Kevin F.;Jackson, Larry R., II;Zeitler, Emily P.
在美国医疗保健系统的许多方面都有关于治疗（心血管和其他方面）的种族和民族差异的记录，并且可以在植入式心律转复除颤器（ICD）患者的选择、咨询和管理中看到。ICD已被证明是预防心源性猝死的有力工具，但在所有合格患者中的使用率并不高。虽然在美国，非白色患者不成比例地符合ICD的条件，但他们不太可能去看专家，接受ICD的咨询，并最终植入ICD。本综述探讨了在ICD患者选择、结局（包括电击有效性）以及一级和二级预防器械植入后监测方面表现出的种族和民族差异。它还强调了在卫生系统，医生和患者层面的吸收障碍，并建议需要进一步研究的领域，以澄清差异，阐明这些差异的驱动力，并调查解决这些问题的策略。
Racial and ethnic differences in treatment—cardiovascular and otherwise—have been documented in many aspects of the American health care system and can be seen in implantable cardioverter-defibrillator (ICD) patient selection, counseling, and management. ICDs have been demonstrated to be a powerful tool in the prevention of sudden cardiac death, yet uptake across all eligible patients has been modest. Although patients who do not identify as White are disproportionately eligible for ICDs in the United States, they are less likely to see specialists, be counseled on ICDs, and ultimately have an ICD implanted. This review explores racial and ethnic differences demonstrated in ICD patient selection, outcomes including shock effectiveness, and postimplantation monitoring for both primary and secondary prevention devices. It also highlights barriers for uptake at the health system, physician, and patient levels and suggests areas of further research needed to clarify the differences, illuminate the driving forces of these differences, and investigate strategies to address them.
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