Race/ethnic disparities in risk factor control and survival in the bypass angioplasty revascularization investigation 2 diabetes (BARI 2D) trial.
Race/ethnic disparities in risk factor control and survival in the bypass angioplasty revascularization investigation 2 diabetes (BARI 2D) trial.
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旁路血管成形术血运重建调查 2 型糖尿病 (BARI 2D) 试验中危险因素控制和生存的种族/民族差异。
DOI：
10.1016/j.amjcard.2013.05.071
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
BARI2DStudyGroup
中科院分区：
文献类型：
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作者：
Beohar,Nirat;Sansing,VeronicaV;Davis,AndrewM;Srinivas,VS;Helmy,Tarek;Althouse,AndrewD;Thomas,StephenB;Brooks,MariaMori;BARI2DStudyGroup
本研究旨在评估种族/民族对心血管风险因素控制和在医疗服务可及性相当的情况下对临床结局的影响。巴里2D试验入组了来自美国和加拿大的1，750名参与者，这些参与者自我报告为非西班牙裔白色人（n = 1，189）、非西班牙裔黑人（n = 349）或西班牙裔（n = 212）人种/种族。参与者患有2型糖尿病和冠状动脉疾病，并随机接受心脏和血糖治疗策略。所有患者均接受了针对心脏危险因素的强化靶向药物治疗。平均随访5.3年。构建Kaplan-Meier生存曲线和考克斯比例风险回归模型，以评估不同种族/民族之间死亡率和心血管结局的潜在差异。死亡和死亡/心肌梗死/卒中的长期风险在人种/种族之间无显著差异（5年死亡：白人11.0%，黑人13.7%，西班牙裔8.7%，p = 0.19;校正风险比1.18黑人与白色，95%置信区间0.84 - 1.67，p = 0.33和0.82西班牙裔与白色，95%置信区间0.51至1.34，p = 0.43）。在1,168例基线时风险因素控制不佳的患者中，在试验期间获得更好风险因素控制的能力与较高的5年生存率相关（0或1，2和3个因素控制的患者分别为71%，86%和95%，p <0.001）;这种模式在每个种族/种族组中观察到。总之，随访期间持续存在的心脏风险特征的显著人种/种族差异并未转化为5年死亡或死亡/MI/卒中的显著差异。
This study sought to evaluate the impact of race/ethnicity on cardiovascular risk factor control and on clinical outcomes in a setting of comparable access to medical care. The BARI 2D trial enrolled 1,750 participants from the United States and Canada that self-reported either White non-Hispanic (n = 1,189), Black non-Hispanic (n = 349), or Hispanic (n = 212) race/ethnicity. Participants had type 2 diabetes and coronary artery disease and were randomized to cardiac and glycemic treatment strategies. All patients received intensive target-based medical treatment for cardiac risk factors. Average follow-up was 5.3 years. Kaplan-Meier survival curves and Cox proportional hazards regression models were constructed to assess potential differences in mortality and cardiovascular outcomes across racial/ethnic groups. Long-term risk of death and death/myocardial infarction/stroke did not vary significantly by race/ethnicity (5-year death: 11.0% Whites, 13.7% Blacks, 8.7% Hispanics, p = 0.19; adjusted hazard ratio 1.18 Black versus White, 95% confidence interval 0.84 to 1.67, p = 0.33 and 0.82 Hispanic versus White, 95% confidence interval 0.51 to 1.34, p = 0.43). Among the 1,168 patients with suboptimal risk factor control at baseline, the ability to attain better risk factor control during the trial was associated with higher 5-year survival (71%, 86% and 95% for patients with 0 or 1, 2, and 3 factors in control, respectively, p <0.001); this pattern was observed within each race/ethnic group. In conclusion, significant race/ethnic differences in cardiac risk profiles that persisted during follow-up did not translate into significant differences in 5-year death or death/MI/stroke.