Disparities for Time to HCM Diagnosis in Contemporary Care, with Ahmad Masri, MD, MS

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Ahmad Masri, MD, MS, discusses a study he led examining disparities in time to diagnosis of hypertrophic cardiomyopathy using Medicare claims data.

New research into the speed of diagnosis of hypertrophic cardiomyopathy in the United States is providing new insight into trends in disease management.

Presented at the American Heart Association Scientific Session 2023, results of the analysis, which leveraged Medicare claims data from 2016-2020, detail disparities in diagnosis of older patients with hypertrophic cardiomyopathy, with evidence of race- and income-based disparities.

Led by Ahmad Masri, MD, MS, assistant professor of medicine and director of the Hypertrophic Cardiomyopathy Center at Oregon Health and Science University, the study was launched to compare age, severity at diagnosis, and time to diagnosis for Medicare patients. From Medicare claims data, investigators identified 48,857 patients with at least 2 hypertrophic cardiomyopathy claims and continuous enrollment from 2 years or more before their first claim for inclusion.

This cohort was 60% women and 81% were non-Hispanic White individuals. Using Medicare claims data, investigators were able to identify age, severity at cardiovascular disease at diagnosis, and time from the first observed indication of heart disease to hypertrophic cardiomyopathy diagnosis.

Results of the analysis indicated Black and Hispanic patients at the time of HCM diagnosis had a 16% higher prior rate of heart failure, and a 11% higher rate of prior major adverse cardiovascular events than their non-Hispanic White counterparts. Investigators pointed out the rate of atrial and non-atrial arrhythmias clinically diagnosed before hypertrophic cardiomyopathy diagnosis was 28% less among Black patients than among White patients (P <.001).

Further analysis suggested Black men in the poorest quartile of counties had a 26% higher rate of HF, 22% higher rate of MACE and a 53% lower rate of clinically diagnosed arrhythmia (all p<0.001) than White men in the wealthiest quartile of counties at the time of diagnosis. Investigators also called attention to results demonstrating median time from the first indication of cardiovascular disease until the diagnosis of hypertrophic cardiomyopathy inn Black and Hispanic patients from the poorest quartile of counties was 347 days longer than for non-Hispanic White patients from the wealthiest quartile of counties (P <.001).

For more on the results of the study, check out our interview with Masri from AHA 2023.

References:

  1. Masri A, Stevens W, Buessing M, et al. Disparities in Speed of Diagnosis of Hypertrophic Cardiomyopathy in the United States. Paper presented at: American Heart Association Scientific Sessions 2023; November 10 - 13; Philadelphia, PA. Accessed November 13, 2023.
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