Racial/Ethnic Disparities in Heart Failure Care Focus of NIH Award for Dr. Khadijah Breathett

Dr. Khadijah Breathett with graphic of treatment options in heart failureKhadijah Breathett, MD, FACC, an assistant professor of medicine in the University of Arizona Division of Cardiology and member of the UA Sarver Heart Center, recently was awarded a 5-year, $875,000 grant from the National Heart, Lung, and Blood Institute (NHLBI), , a unit of the National Institutes of Health (NIH), for her research on racial inequities in advanced heart treatment for African-Americans.

Dr. Breathett, who joined the UA College of Medicine – Tucson faculty last fall after two research fellowships, presented on that research at the 2018-19 inaugural Medicine Grand Rounds on Aug. 8, noting that African-Americans have two to three times higher heart failure rates but often are not candidates for heart transplant or implantation of left ventricular assist devices (LVADs).

Of 6.5 million Americans living with heart failure today, 50 percent die within five years of diagnosis, so—Dr. Breathett noted—prevention is the best cure, which requires better focus on risk factors particularly for women who have higher prevalence of heart failure. But African Americans are less likely to receive care by a cardiologist during an ICU admission for heart failure, she points out.

The title of her NHLBI project is, “Addressing Individual Provider Bias and Group Decision-Making in Selection of Advanced Heart Failure Therapies in Racial/Ethnic Minorities” (NHLBI/NIH Award No. K01HL142848). Some of this bias may be due to real or perceived socioeconomic stereotypes that may be outdated. Some may be simply unconscious bias clinicians may not be aware that they are exhibiting.

Regardless, her goal is to improve clinical decision-making for advanced therapies for heart failure to help reduce such inequities.

EXTRA INFO: Medicine Grand Rounds, Aug. 15, 2018

Dr. James SlighSpeaking at the next Grand Rounds for the UA Department of Medicine will be Division of Dermatology Chief and Associate Director of the UA Skin Cancer Institute James Sligh, MD, PhD. His topic: “Advances in Non-Surgical Treatments for Skin Cancer.”

All lectures occur in UAHS 5403 | Noon-1 p.m. | Watch It LIVE!

You also can watch all lectures via video conference at Banner – University Medical Center South, Conf. Room 3030, 2800 E. Ajo Way. A light lunch is served. All Medicine Grand Rounds are archived at this link: https://streaming.biocom.arizona.edu/categories/?id=10

                    Dr. Breathett with slide on disparities in heart failure for women  A kaleidoscope of factors in how bias can enter decision-making  Determinants of health assist in weeding out bias in treatment

                    Dr. Breathett lectures at Aug. 8 Medicine Grand Rounds. View other photos on the UA Sarver Heart Center and Department of Medicine Facebook webpages.

“My previous work has addressed racial/ethnic and gender disparities along the prevention-treatment-cure continuum of heart failure. This grant moves the needle forward by developing tools to improve healthcare provider decision-making, specifically to seek greater health equity in advanced heart failure,” Dr. Breathett said.

“I have been working with a talented group of students and housestaff to address racial and gender bias using national and international surveys: UAHS internal medicine resident Sade Solola, MD; UAHS medical school students Leanne Zabala and Kathryn Ht; and University of Rochester undergraduate student Luis Luy (who completed the SEPA-NIH sponsored summer research program at UAHS with our team). We have surveyed over a 1,000 individuals and expect to have an abstract prepared within the next month.”

The K01 grant from NHLBI is a mentored research scientist development award designed to help groom junior investigators. Dr. Breathett’s mentor team includes:

  • Dr. Khadijah Breathett answers questions at the end of her grand rounds lecture with Dr. Nancy Sweitzer at leftNancy Sweitzer, MD, PhD (pictured on left at right with Dr. Breathett), professor of medicine, chief, Division of Cardiology, and director, UA Sarver Heart Center;
  • Marylyn M. McEwen , PhD, PHCNS-BC, professor of nursing and public health, and the Gladys E. Sorensen Endowed Professor of Nursing, UA College of Nursing;
  • Jeff Stone, PhD, professor of psychology, UA College of Medicine – Tucson and School of Mind, Brain and Behavior, UA College of Science, and a research associate, UA Cancer Center;
  • Elizabeth Calhoun, PhD, professor of community, environment and policy, and executive director, Center for Population Science and Discovery, UA Mel and Enid Zuckerman College of Public Health, and associate vice president for population health sciences, UA Health Sciences; and
  • Janice Crist, PhD, RN, associate professor of nursing, UA College of Nursing.

Dr. Breathett earned her undergraduate degree in biomedical engineering at Northwestern University, in Evanston, Ill. She completed her medical degree at the University of Michigan Medical School in Ann Arbor, afterward doing her internal medicine residency at Duke University Medical Center in Durham, N.C. She completed a cardiovascular disease fellowship and an advanced heart failure and transplant cardiology fellowship at Ohio State University’s Wexner Medical Center in Columbus.

From 2015 to 2017, Dr. Breathett completed a NIH T32 Cardiovascular/Obesity Outcomes Fellowship, and also a American Heart Association Advanced Heart Failure/Transplant Outcomes Research Fellowship for Strategically Focused Research Network at the University of Colorado Anschutz Medical Center in Aurora. She has conducted outcomes studies, observational population studies, and community interventions focused on reducing racial/ethnic and gender disparities in cardiovascular disease.

Dr. Breathett joined the faculty at the UA College of Medicine – Tucson in fall 2017. At that time, she received a UAHS Strategic Priorities Faculty Initiative Grant. In the past year, she also she was named a Fellow of the American College of Cardiology, received a top reviewer award from the journal Circulation: Cardiovascular Quality & Outcomes, and an article she was lead author on in JACC: Heart Failure in February 2018 was tagged as one of the “most impactful” of the past year.

Three other articles she cited as impactful with respect to her research are:
Covers for March 2018 Journal of Racial and Ethnic Health Disparities, May 2018 JACC: Heart Failure and August 2018 Circulation: Heart Failure• “Factors Related to Physician Clinical Decision-Making for African-American and Hispanic Patients: A Qualitative Meta-Synthesis,” in the Journal of Racial and Ethnic Health Disparities in March 2018 (with mentors Drs. Calhoun, McEwen and Sweitzer among her co-authors);
• “African-Americans Are Less Likely to Receive Care by a Cardiologist during an Intensive Care Visit Admission for Heart Failure,” JACC: Heart Failure in May 2018; and,
• "Temporal Trends in Contemporary Use of Ventricular Assist Devices by Race and Ethnicity," in Circulation: Heart Failure's August 2018 issue (with mentors Drs. Calhoun, McEwen, Stone and Sweitzer among co-authors). 

“Health equity will require a collaborative effort from patients, healthcare providers, administrators, and community leaders,” Dr. Breathett said in closing. “With a united front, we can reduce racial/ethnic and gender disparities one step at a time.”

Release Date: 
08/13/2018 - 5:15pm