Black patients less likely to receive heart transplants, heart pumps: Study

Researchers found racial disparities are evident in the treatment of patients for advanced heart failure. The gap could be due to racial bias, they said.

White patients are more likely than Black patients to receive heart transplants and devices that help the heart function properly, researchers found in a recent study.

Black patients received transplants and pumps about half as often as white patients, according to the study, which was supported by the National Institutes of Health. The findings were published in Circulation: Heart Failure.

Researchers said the disparities could be attributed to racial bias.

“This residual inequity may be a consequence of structural racism and discrimination or provider bias impacting decision-making,” the researchers concluded.

Researchers tracked 377 patients with heart failure at 21 health centers. They found 22% of white patients received a heart transplant or a ventricular assist device (VAD), or heart pump, which helps the heart pump blood to the rest of the body.

Conversely, 11% of Black patients received either a transplant or the heart pump, according to the study.

Researchers said the disparity in treatments occurred even after accounting for the severity of heart failure, quality of life and the social determinants of health.

Black patients were no less likely to be willing to get heart pumps or transplants. The authors also said preferences for either the ventricular assist device or other life-sustaining treatments were similar regardless of race and didn’t explain the racial disparities.

Thomas M. Cascino, the lead author and a cardiologist at the University of Michigan Health Frankel Cardiovascular Center, said the study should inspire a call to action.

“The totality of the evidence suggests that we as heart failure providers are perpetuating current inequities,” Cascino said in an NIH news release. “However, recognizing disparities isn’t enough. As physicians and health care providers, we must find ways to create equitable change.”

Researchers said they did not find ties between the race of the patients and death rates. Among Black patients, 18% died, while 13% of white patients in the study died.

The study reveals the need for better training, said Wendy C. Taddei-Peters, a co-author of the study and a clinical trials project official within the National Heart, Lung, and Blood Institute.

“The lives disabled or lost are simply too many,” Taddei-Peters said in the release. “An immediate step could be to require implicit bias training, particularly for transplant and VAD team members.”

Medical centers should enlist experts in healthcare disparities who can work with cardiology teams and identify points in treatment decisions that could be affected by bias.

“Disparity experts can identify these biases and barriers in real-time, provide learning opportunities, and promote equity,” Taddei-Peters said in a statement. “This can be especially valuable for centers where the demographics of health care providers may not reflect the patients they serve.”

The data stemmed from a two-year, NIH-backed study of heart failure known as the Registry Evaluation of Vital Information for VADs in Ambulatory Life, dubbed REVIVAL.

The study is the latest revealing disparities in healthcare among racial groups.

Black and Latinx patients were much more likely to have longer delays for cancer treatment, according to a study published in Jama Network Open in July.

Black patients were six times more likely than white patients to experience cancer treatment delays that exceeded four weeks, the study found. Latinx adults were nearly three times more likely than white adults to see treatment delayed for more than four weeks.

Those delays among patients who were diagnosed with cancer are troubling, since they suggest that one or more courses of treatment were delayed or canceled, the researchers said.