Komlan E.B. Guedze, MD1, Kojo-Frimpong B. Awuah, MD2, Mutabi Erasmus, MD2, Chidera Onwuzo, MD3, Tyrell Daniel, MD4, Rashid Abdel-Razeq, MD5 1Franciscan Alliance, Olympia Fields, IL; 2Allegheny Health Network, Pittsburgh, PA; 3State University of New York Upstate Medical University, Syracuse, NY; 4Sentara Northern Virginia Medical Center, Woodbridge, VA; 5Cleveland Clinic Foundation, Cleveland, OH Introduction:
Racial disparities in health outcomes are well-documented in both acute pancreatitis (AP) and cirrhosis, yet their combined impact on cardiac complications remains underexplored. Socioeconomic inequities, differential comorbidity burdens, and systemic healthcare barriers contribute to these disparities. This study investigates one-year cardiac outcomes among racial groups in patients with coexisting AP and cirrhosis, providing critical insights into inequities in healthcare and outcomes. Methods:
A retrospective cohort study was conducted using the TriNetX database, analyzing 26,160 patients with AP and cirrhosis stratified by self-identified race (Black, White, Hispanic, and Other). Primary outcomes included the incidence of cardiac arrest, heart failure (HF), and arrhythmias. Propensity score matching accounted for demographic and clinical covariates, ensuring balanced comparisons across racial groups. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated to assess disparities. Results: Black patients exhibited disproportionately higher rates of cardiac complications, including cardiac arrest (HR: 2.93; CI: 2.34–3.65; p< 0.001) and HF (HR: 1.67; CI: 1.35–2.07; p< 0.001), compared to White patients. Hispanic patients showed an elevated risk of arrhythmias (HR: 1.22; CI: 1.01–1.48; p=0.042). These disparities persisted despite adjustments for socioeconomic status and clinical factors, indicating the significant role of structural inequities and potential biological differences. Discussion: Racial disparities in cardiac outcomes among cirrhotic AP patients highlight systemic inequities in healthcare delivery and biological vulnerabilities in underserved populations. Black and Hispanic patients face disproportionately higher risks of severe complications, underscoring the need for culturally tailored interventions and equitable healthcare policies. Future research should focus on mechanisms driving these disparities and effective strategies to mitigate them.
Figure: Table 1: Baseline characteristics of patients with acute pancreatitis (AP) stratified into two cohorts: Cohort 1 includes AP patients with cirrhosis, and Cohort 2 includes AP patients without cirrhosis. Demographic variables, comorbid conditions, and diagnoses were compared to highlight differences between the groups. Before propensity score matching, significant imbalances were observed, with cirrhotic patients showing higher rates of alcohol abuse, chronic kidney disease, and nicotine dependence. After matching, standard differences were markedly reduced, ensuring comparability between cohorts and enabling robust analysis of the impact of cirrhosis on 1-year outcomes in AP.
Figure: Figure 1: Forest Plot of Racial Disparities in Cardiac Outcomes This forest plot highlights hazard ratios (HR) and 95% confidence intervals (CI) for racial disparities in cardiac outcomes. Black patients demonstrated a significantly higher risk of cardiac arrest (HR = 3.0) and heart failure (HR = 1.5) compared to White patients. Hispanic patients showed an increased risk of arrhythmias (HR = 1.2) compared to White patients. The dashed vertical line at HR = 1 represents no effect, and all reported outcomes indicate statistically significant disparities, emphasizing the need for addressing racial inequities in healthcare.
Disclosures: Komlan Guedze indicated no relevant financial relationships. Kojo-Frimpong B. Awuah indicated no relevant financial relationships. Mutabi Erasmus indicated no relevant financial relationships. Chidera Onwuzo indicated no relevant financial relationships. Tyrell Daniel indicated no relevant financial relationships. Rashid Abdel-Razeq indicated no relevant financial relationships.
Komlan E.B. Guedze, MD1, Kojo-Frimpong B. Awuah, MD2, Mutabi Erasmus, MD2, Chidera Onwuzo, MD3, Tyrell Daniel, MD4, Rashid Abdel-Razeq, MD5. P3708 - Racial Disparities in Cardiac Outcomes Among Cirrhotic Patients With Acute Pancreatitis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
