Key result
Black race is linked to ~40% lower odds of postarrest left heart catheterization vs. White patients.
Why the study?
Effective postarrest care facilitates optimal outcomes for out-of-hospital cardiac arrest, yet relatively little research had evaluated whether racial or ethnic disparities exist in postarrest workup and management.
Are there racial or ethnic disparities in the rates of postarrest cardiac interventions among patients surviving to admission after out-of-hospital cardiac arrest?
Cohort (n=58,394)
Yes
Are there racial or ethnic disparities in the rates of postarrest cardiac interventions among patients surviving to admission after out-of-hospital cardiac arrest?
Significant racial and ethnic disparities exist in postarrest cardiac workup and management, with Black and Hispanic/Latino patients being markedly less likely to undergo invasive cardiac procedures such as catheterization, PCI, VAD, and AICD placement after out-of-hospital cardiac arrest compared to White patients.
Answers are grounded in this paper and cite their sources.
Supports auditing institutional OHCA care pathways to ensure equitable access to invasive procedures; leaves open the specific systemic or clinical drivers behind these treatment gaps.
BACKGROUND: Effective postarrest care facilitates optimal outcomes for out-of-hospital cardiac arrest. Relatively little research has evaluated whether there may be racial or ethnic disparities in the workup and management of the patient post arrest. METHODS: We retrospectively studied out-of-hospital cardiac arrests using the TriNetX research database. We defined out-of-hospital cardiac arrest as any emergency department visit (2013-2024) with a diagnosis of cardiac arrest and included patients who survived to admission. Multivariate adjusted logistic regression was used to compare rates of the following cardiac interventions across race or ethnicity: (1) echocardiography; (2) left heart catheterization; (3) percutaneous coronary intervention; (4) ventricular assist device placement; and (5) automated implantable cardioverter-defibrillator placement. RESULTS: A total of 58 394 cases of out-of-hospital cardiac arrest met inclusion criteria. Compared with White patients (left heart catheterization: 13.9%, percutaneous coronary intervention: 7.1%, ventricular assist device: 3.0%, automated implantable cardioverter-defibrillator: 0.9%), Black patients had lower odds of receiving left heart catheterization (7.2%, adjusted odds ratio [aOR], 0.60 [95% CI, 0.55-0.64]), percutaneous coronary intervention (2.6%, aOR, 0.47 [95% CI, 0.42-0.53]), ventricular assist device placement (1.6%, aOR, 0.70 [95% CI, 0.60-0.80]), and automated implantable cardioverter-defibrillator placement (0.4%, aOR, 0.53 [95% CI, 0.41-0.70]). Hispanic/Latino patients were also less likely to receive left heart catheterization (8.9%, aOR, 0.72 [95% CI, 0.64-0.80]), percutaneous coronary intervention (3.7%, aOR, 0.63 [95% CI, 0.53-0.74]), and automated implantable cardioverter-defibrillator placement (0.4%, aOR, 0.52 [95% CI, 0.33-0.81]). CONCLUSIONS: Our large multicenter analysis identifies racial or ethnic disparities in postarrest cardiac workup and management. Further research is needed to identify potential causes for these disparities with the hope of developing strategies to address them.
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Shekhar et al. (2026) conducted a cohort in Out-of-hospital cardiac arrest (n=58,394). Black or Hispanic/Latino race/ethnicity vs. White race/ethnicity was evaluated on Left heart catheterization (OR 0.60, 95% CI 0.55-0.64). Black and Hispanic/Latino patients had lower odds of receiving left heart catheterization after cardiac arrest than White patients.
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