Risk of Major Adverse Cardiovascular Events and Major Hemorrhage Among White and Black Patients Undergoing Percutaneous Coronary Intervention
Risk of Major Adverse Cardiovascular Events and Major Hemorrhage Among White and Black Patients Undergoing Percutaneous Coronary Intervention
复制标题
DOI：
10.1161/jaha.119.012874
复制
发表时间：
2019-11-19
影响因子：
5.4
通讯作者：
Limdi, Nita A.
中科院分区：
文献类型：
--
作者：
Cai, Anping;Dillon, Chrisly;Limdi, Nita A.
背景--经皮冠状动脉介入治疗后主要不良心血管事件(MACE)和大出血(HEM)的种族差异数据有限。造成这些差异的因素尚不清楚。方法和结果-PRIME-GGAT(提高药物有效性的药物基因组资源-基因导引的抗血小板治疗)是一个前瞻性队列。入选接受经皮冠状动脉介入治疗的18岁患者，并进行长达1年的随访。使用发生率比率来评估MACE和HEM风险的种族差异。进行了顺序累积调整分析，以确定造成这些差异的因素。919名患者的数据被包括在分析中。与白人患者相比，黑人患者(n=203，占队列的22.1%)更年轻，更有可能是女性，吸烟，体重指数较高，社会经济地位较低，糖尿病和中重度慢性肾脏疾病的患病率较高，并表现为急性冠状动脉综合征和接受紧急经皮冠状动脉介入治疗。MACE发生率为34.1%/100人年，18.2%/100人年，P
Background-Data on racial disparities in major adverse cardiovascular events (MACE) and major hemorrhage (HEM) after percutaneous coronary intervention are limited. Factors contributing to these disparities are unknown.Methods and Results-PRiME-GGAT (Pharmacogenomic Resource to Improve Medication Effectiveness-Genotype-Guided Antiplatelet Therapy) is a prospective cohort. Patients aged >= 18 years undergoing percutaneous coronary intervention were enrolled and followed for up to 1 year. Racial disparities in risk of MACE and HEM were assessed using an incident rate ratio. Sequential cumulative adjustment analyses were performed to identify factors contributing to these disparities. Data from 919 patients were included in the analysis. Compared with white patients, black patients (n=203; 22.1% of the cohort) were younger and were more likely to be female, to be a smoker, and to have higher body mass index, lower socioeconomic status, higher prevalence of diabetes mellitus and moderate to severe chronic kidney disease, and presentation with acute coronary syndrome and to undergo urgent percutaneous coronary intervention. The incident rates of MACE (34.1% versus 18.2% per 100 person-years, P