Trends in Acute Myocardial Infarction by Race and Ethnicity
Trends in Acute Myocardial Infarction by Race and Ethnicity
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DOI：
10.1161/jaha.119.013542
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发表时间：
2020-03-03
影响因子：
5.4
通讯作者：
Reynolds, Kristi
中科院分区：
文献类型：
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作者：
Chi, Gloria C.;Kanter, Michael H.;Reynolds, Kristi
不同种族/民族的急性心肌梗死（AMI）发病率趋势在很大程度上是未知的，这给理解种族/民族在AMI发生中的作用带来了障碍。方法和结果我们使用出院诊断代码对2000年至2014年期间Kaiser Permanente南加州会员的AMI住院情况进行了识别，年龄为bb0 = 35岁。我们排除了缺少种族/民族信息的住院患者。我们计算了AMI、st段抬高型心肌梗死和非st段抬高型心肌梗死的年发病率（年龄和性别标准化到2010年美国人口普查），并按种族/民族（西班牙裔和非西班牙裔种族群体：亚洲或太平洋岛民、黑人和白人）划分。使用泊松回归，我们估计了AMI、非st段抬高型心肌梗死和st段抬高型心肌梗死发病率的年度百分比变化，按种族/民族和种族/民族对之间的AMI发病率比进行了调整，并对年龄和性别进行了调整。我们纳入了18 630 776人年的观察，并确定了44 142例AMI住院病例。2000 - 2014年间，AMI、非st段抬高型心肌梗死和st段抬高型心肌梗死的下降率分别为48.7%、34.2%和69.8%。年龄和性别标准化的AMI住院率/10万人年在西班牙裔（从307人降至162人）、亚洲人或太平洋岛民（从271人降至158人）、黑人（从347人降至199人）和白人（从376人降至189人）中均有所下降。年百分比变化范围为-2.99%至-4.75%，但黑人的年百分比变化在2000 - 2009年为-5.32%，在2010 - 2014年为-1.03%。结论2000 - 2014年，各种族AMI、非st段抬高型心肌梗死和st段抬高型心肌梗死住院发生率均显著下降。尽管种族/民族之间的比率在缩小，但差异仍然存在。了解这些差异有助于确定AMI预防和管理中未满足的需求，从而指导有针对性的干预措施。
Background Trends in acute myocardial infarction (AMI) incidence rates for diverse races/ethnicities are largely unknown, presenting barriers to understanding the role of race/ethnicity in AMI occurrence.Methods and Results We identified AMI hospitalizations for Kaiser Permanente Southern California members, aged >= 35 years, during 2000 to 2014 using discharge diagnostic codes. We excluded hospitalizations with missing race/ethnicity information. We calculated annual incidence rates (age and sex standardized to the 2010 US census population) for AMI, ST-segment-elevation myocardial infarction, and non-ST-segment-elevation myocardial infarction by race/ethnicity (Hispanic and non-Hispanic racial groups: Asian or Pacific Islander, black, and white). Using Poisson regression, we estimated annual percentage change in AMI, non-ST-segment-elevation myocardial infarction, and ST-segment-elevation myocardial infarction incidence by race/ethnicity and AMI incidence rate ratios between race/ethnicity pairs, adjusting for age and sex. We included 18 630 776 person-years of observation and identified 44 142 AMI hospitalizations. During 2000 to 2014, declines in AMI, non-ST-segment-elevation myocardial infarction, and ST-segment-elevation myocardial infarction were 48.7%, 34.2%, and 69.8%, respectively. Age- and sex-standardized AMI hospitalization rates/100 000 person-years declined for Hispanics (from 307 to 162), Asians or Pacific Islanders (from 271 to 158), blacks (from 347 to 199), and whites (from 376 to 189). Annual percentage changes ranged from -2.99% to -4.75%, except for blacks, whose annual percentage change was -5.32% during 2000 to 2009 and -1.03% during 2010 to 2014.Conclusions During 2000 to 2014, AMI, non-ST-segment-elevation myocardial infarction, and ST-segment-elevation myocardial infarction hospitalization incidence rates declined substantially for each race/ethnic group. Despite narrowing rates among races/ethnicities, differences persist. Understanding these differences can help identify unmet needs in AMI prevention and management to guide targeted interventions.