Heart Failure Incidence and Mortality in the Southern Community Cohort Study.
Heart Failure Incidence and Mortality in the Southern Community Cohort Study.
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DOI：
10.1161/circheartfailure.116.003553
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发表时间：
2017-03
期刊：
影响因子：
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通讯作者：
Lipworth L
中科院分区：
文献类型：
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作者：
Akwo EA;Kabagambe EK;Wang TJ;Harrell FE Jr;Blot WJ;Mumma M;Gupta DK;Lipworth L
关于低收入和少数民族人群心力衰竭发病率的数据很少。我们的目标是按种族和性别调查美国东南部低收入成年人的心力衰竭发病率和心力衰竭后生存率。参与者是 2002 年至 2009 年期间参加南方社区队列研究 (SCCS) 的 27,078 名白人和黑人男性和女性，他们没有心力衰竭病史，并且正在接受医疗保险或医疗补助服务中心 (CMS)。截至 2010 年 12 月 31 日的心力衰竭事件诊断是通过与 CMS 研究文件的链接使用 ICD-9 代码 428.x 确定的。大多数参与者是黑人 (68.8%)、女性 (62.6%)，年收入低于 15,000 美元 (69.7%)；平均年龄为 55.5 (10.4) 岁。心力衰竭的危险因素很常见：高血压（62.5%）、糖尿病（26.5%）、心肌梗死（8.6%）和肥胖（44.8%）。在中位随访 5.2 年中，4,341 名参与者被诊断患有心力衰竭。白人女性、白人男性、黑人男性和黑人女性的年龄标准化发病率分别为 34.8、37.3、34.9 和 35.6 PY/1000，明显高于之前报道的水平。在心力衰竭病例中，中位随访时间为 2.3 年，有 952 例死亡。男性的生存率较低；与白人女性相比，白人男性、黑人男性和黑人女性的风险比和 95% 置信区间分别为 1.63 (1.27–2.08)、1.38 (1.11–1.72) 和 0.90 (0.73–1.12)。在这个低收入人群中，所有种族性别群体的心力衰竭发病率均高于之前报道的其他群体。 SCCS 是一个独特的资源，用于调查其他现有人群中代表性不足的部分人群的心力衰竭风险决定因素。
There is a paucity of data regarding HF incidence among low-income and minority populations. Our objective was to investigate HF incidence and post-HF survival by race and sex among low-income adults in the southeastern US. Participants were 27,078 white and black men and women enrolled during 2002–2009 in the Southern Community Cohort Study (SCCS) who had no history of HF and were receiving Centers for Medicare or Medicaid services (CMS). Incident HF diagnoses through December 31, 2010 were ascertained using ICD-9 codes 428.x via linkage with CMS research files. Most participants were black (68.8%), women (62.6%) and earned < $15,000/year (69.7%); mean age was 55.5 (10.4) years. Risk factors for HF were common: hypertension (62.5%), diabetes (26.5%), myocardial infarction (8.6%) and obesity (44.8%). Over a median follow-up of 5.2 years, 4,341 participants were diagnosed with HF. The age-standardized incidence rates were 34.8, 37.3, 34.9 and 35.6 PY/1000 in white women, white men, black men and black women, respectively, remarkably higher than previously reported. Among HF cases, 952 deaths occurred over a median follow-up 2.3 years. Men had lower survival; hazard ratios and 95% confidence intervals were 1.63 (1.27–2.08), 1.38 (1.11–1.72) and 0.90 (0.73–1.12) for white men, black men and black women compared with white women. In this low-income population, HF incidence was higher for all race-sex groups than previously reported in other cohorts. The SCCS is a unique resource to investigate determinants of HF risk in a segment of the population underrepresented in other existing cohorts.