Racial differences in the outcomes of patients with diastolic heart failure
Racial differences in the outcomes of patients with diastolic heart failure
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DOI：
10.1016/j.ahj.2004.01.017
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发表时间：
2004-07-01
影响因子：
4.8
通讯作者：
O'Connor, CM
中科院分区：
文献类型：
--
作者：
East, MA;Peterson, ED;O'Connor, CM
研究背景：半数以上的充血性心力衰竭患者左心室收缩功能正常。这是特别常见的非洲裔美国人的患者，但一直很少有研究这种疾病的长期自然史，在非洲裔美国人和白色patients.Methods我们研究了2740白色和563名非洲裔美国人的II类至IV症状和保留收缩功能（射血分数>40）确定在杜克心血管数据库从1984年至1996年。结果非裔美国人和白色患者的5年生存率分别为68%和70（P = .55）;然而，在调整已知的危险因素后，非裔美国人患者的死亡风险明显高于白色患者（风险比[HR]，1.34; 95% CI，1.13-1.60）。这种生存率的种族差异在非缺血性病因的患者中最为突出（HR，1.6; 95% CI，1.2-2.0）与缺血性心力衰竭患者相比（H R，1.1;结论在左室收缩功能保留的心力衰竭患者中，非裔美国人患者的长期预后比白色患者差。这些结果很重要，因为这种情况在非洲裔美国人患者中的患病率及其对许多心力衰竭治疗的潜在异质性反应。
Background More than half of all patients with congestive heart failure have preserved left ventricular systolic function. This is particularly common in African American patients, yet there have been few studies examining the long-term natural history of this disorder in African-American and white patients.Methods We studied 2740 white and 563 African American patients with class II to IV symptoms and preserved systolic function (ejection fraction >40) identified in the Duke Cardiovascular Databank from 1984 to 1996. Unadjusted and adjusted 5-year survival rate comparisons were performed with Kaplan-Meier and Cox proportional hazards models, respectively.Results The 5-year survival rates were 68% for African American patients and 70% for white patients (P = .55); However, after adjusting for known risk factors, African American patients had a significantly higher mortality risk than white patients (hazard ratio [HR], 1.34; 95% CI, 1.13-1.60). This racial difference in survival rate was most prominent in patients with a non-ischemic etiology (HR, 1.6; 95% CI, 1.2-2.0) as compared with patients with ischemic heart failure (H R, 1.1; 95 % CI, 0.9-1.4).Conclusion Among patients with heart failure and preserved left ventricular systolic function, African American patients have a worse long-term prognosis than white patients. These results are important because of the prevalence of this condition in African American patients and their potential heterogeneous response to many heart failure therapies.