Yasmin F, Salman A, Asghar MS, Moeed A, Shaharyar M, Alraies MC. Racial disparities in the mortality and health-care resource utilization of heart failure patients with chronic obstructive pulmonary disease. World J Cardiol 2025; 17(12): 111150 [DOI: 10.4330/wjc.v17.i12.111150]
Corresponding Author of This Article
Muhammad Sohaib Asghar, MD, Department of Internal Medicine, AdventHealth, 4421 Sun N’ Lake Boulevard, Suite B, Sebring, FL 33872, United States. sohaib_asghar123@yahoo.com
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Cardiac & Cardiovascular Systems
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Letter to the Editor
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 26, 2025 (publication date) through Dec 24, 2025
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World Journal of Cardiology
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1949-8462
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Yasmin F, Salman A, Asghar MS, Moeed A, Shaharyar M, Alraies MC. Racial disparities in the mortality and health-care resource utilization of heart failure patients with chronic obstructive pulmonary disease. World J Cardiol 2025; 17(12): 111150 [DOI: 10.4330/wjc.v17.i12.111150]
World J Cardiol. Dec 26, 2025; 17(12): 111150 Published online Dec 26, 2025. doi: 10.4330/wjc.v17.i12.111150
Racial disparities in the mortality and health-care resource utilization of heart failure patients with chronic obstructive pulmonary disease
Farah Yasmin, Afia Salman, Muhammad Sohaib Asghar, Abdul Moeed, Maryam Shaharyar, M Chadi Alraies
Farah Yasmin, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06511, United States
Afia Salman, Abdul Moeed, Department of Internal Medicine, Dow University of Health Sciences, Karachi 74200, Sindh, Pakistan
Muhammad Sohaib Asghar, Department of Internal Medicine, AdventHealth, Sebring, FL 33872, United States
Maryam Shaharyar, Department of Internal Medicine, Karachi Medical and Dental College, Karachi 74800, Sindh, Pakistan
M Chadi Alraies, Department of Internal Medicine, Wayne State University, Detroit Medical Center, Detroit Heart Hospital, Detroit, MI 48201, United States
Author contributions: Yasmin F, Salman A, and Moeed A contributed to the writing original draft; Yasmin F contributed to the conceptualization of this manuscript; Salman A and Moeed A participated in the data curation; Asghar MS and Alraies MC contributed to the writing review and editing of this manuscript; Asghar MS contributed to the formal analysis and supervision; Shaharyar M contributed to the software, visualization, and writing review; Alraies MC contributed to the validation and project administration.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Muhammad Sohaib Asghar, MD, Department of Internal Medicine, AdventHealth, 4421 Sun N’ Lake Boulevard, Suite B, Sebring, FL 33872, United States. sohaib_asghar123@yahoo.com
Received: June 24, 2025 Revised: July 23, 2025 Accepted: November 14, 2025 Published online: December 26, 2025 Processing time: 183 Days and 17.3 Hours
Abstract
Increased mortality rates in chronic obstructive pulmonary disease (COPD) patients with heart failure (HF) are believed to be driven by various factors, including disparities in access to healthcare services and shifting dynamics of the population characteristics. In this study, we examined the racial and ethnic disparities in the clinical outcomes of HF in COPD patients in the United States, analyzing data from the Nationwide Inpatient Sample database. The database was searched retrospectively from 2016 to 2022 to identify COPD and HF patients by International Classification of Diseases-10 codes. A total of 2445545 individuals were included of which 76% were Whites, 16% were Blacks, 5% Hispanics and 3% others. Whites were significantly older than other populations (P < 0.001), and a significantly higher proportion of Blacks were females compared to other racial groups. Regarding clinical outcomes, Black COPD patients with HF had the lowest mortality rates while it was similar between Whites and Hispanics (P < 0.001). Compared to Whites, the adjusted odds ratio was significantly lower for Blacks, 0.797 [95% confidence interval (CI): 0.783-0.812; P < 0.001] and Hispanics, 0.956 (95%CI: 0.932-0.981; P = 0.001). Other racial groups had significantly higher mortality compared to Whites, with an adjusted odds ratio of 1.131 (95%CI: 1.099-1.164; P < 0.001). Individuals from other racial groups had significantly longer hospital stay, and hospitalization cost adjusted for inflation. Cardiac arrest was the strongest predictor (P < 0.001) for in-hospital mortality in all racial groups.
Core Tip: This study analyzed data from the Nationwide Inpatient Sample database to assess the racial disparities in the clinical outcomes of heart failure in chronic obstructive pulmonary disease patients in the United States from 2016 to 2022. The study underscored persistent racial disparities in clinical management and outcomes of chronic obstructive pulmonary disease patients with heart failure, highlighting areas for targeted interventions to promote equitable healthcare delivery.
