CHARACTERISTICS OF BLACK PATIENTS ADMITTED TO CORONARY-CARE UNITS IN METROPOLITAN SEATTLE - RESULTS FROM THE MYOCARDIAL-INFARCTION-TRIAGE-AND-INTERVENTION-REGISTRY (MITI)
CHARACTERISTICS OF BLACK PATIENTS ADMITTED TO CORONARY-CARE UNITS IN METROPOLITAN SEATTLE - RESULTS FROM THE MYOCARDIAL-INFARCTION-TRIAGE-AND-INTERVENTION-REGISTRY (MITI)
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DOI：
10.1016/0002-9149(91)90092-y
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发表时间：
1991-01-01
影响因子：
2.8
通讯作者：
WEAVER, WD
中科院分区：
文献类型：
--
作者：
MAYNARD, C;LITWIN, PE;WEAVER, WD
自1988年以来，641名黑人和11,892名白色患者因假定的心源性胸痛被收住西雅图大都市19家医院的冠心病监护室。 黑人男性和女性更年轻（58比66，p < 0.0001），更常入住中心城市医院（p < 0.0001），发生急性心肌梗死（AMI）的证据更少（19比23%，p = 0.01）。 在2，870例AMI患者中，黑人（n = 121）更年轻（59 vs 67，p < 0.0001），既往冠状动脉旁路移植术较少（2 vs 10%，p = 0.005），既往高血压较多（67 vs 46%，p < 0.0001）。 住院期间，白人（n = 2，749）的冠状动脉血管成形术（18 vs 10%，p = 0.03）和冠状动脉旁路移植术（10 vs 4%，p = 0.04）的发生率较高，尽管溶栓治疗和心导管插入术在两组中的使用率相同。 黑人和白色患者的住院死亡率分别为7.4%和13.1%（p = 0.07）。 然而，经Logistic回归调整关键人口统计学和临床变量后，这种差异并不明显（p = 0.38）。其他研究者提出了关于黑人早发冠状动脉疾病、过度全身性高血压和不同干预措施的问题。 尽管在年龄、转诊模式和冠状动脉血管成形术和旁路手术的使用方面存在差异，但西雅图大都市的黑人和白色AMI患者的结局相似。
Since 1988, 641 black and 11,892 white patients with chest pain of presumed cardiac origin have been admitted to coronary care units in 19 hospitals in metropolitan Seattle. Black men and women were younger (58 vs 66, p < 0.0001), more often admitted to central city hospitals (p < 0.0001), and developed evidence of acute myocardial infarction (AMI) less often (19 vs 23%, p = 0.01). In the subset of 2,870 AMI patients, blacks (n = 121) were younger (59 vs 67, p < 0.0001) and had less prior coronary artery bypass graft surgery (2 vs 10%, p = 0.005) and more prior hypertension (67 vs 46%, p < 0.0001). During hospitalization, whites (n = 2,749) had higher rates of coronary angioplasty (18 vs 10%, p = 0.03) and coronary artery bypass graft surgery (10 vs 4%, p = 0.04), although thrombolytic therapy and cardiac catheterization were used equally in the 2 groups. Hospital mortality was 7.4% for black and 13.1% for white patients (p = 0.07). However, after adjustment for key demographic and clinical variables by logistic regression, this difference was not as apparent (p = 0.38).Questions about the premature onset of coronary artery disease, excess systemic hypertension, and the differential use of interventions in black persons have been raised by other investigators. Despite differences in age, referral patterns and the use of coronary angioplasty and bypass surgery, black and white patients with AMI in metropolitan Seattle had similar outcomes.