Ethnicity and long-term outcome after an acute coronary event. Multicenter Myocardial Ischemia Research Group.
Ethnicity and long-term outcome after an acute coronary event. Multicenter Myocardial Ischemia Research Group.
复制标题
急性冠状动脉事件后的种族和长期结果。
DOI：
10.1016/s0002-8703(99)70153-5
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发表时间：
1999
影响因子：
4.8
通讯作者：
Kawai,C
中科院分区：
文献类型：
--
作者：
Nakamura,Y;Moss,AJ;Brown,MW;Kinoshita,M;Kawai,C
背景 种族对心肌梗死后长期结局的作用尚不完全清楚。方法和结果我们分析了北美和日本心肌缺血多中心研究的数据。我们招募了急性心肌梗死（MI）或不稳定心绞痛后的患者，随访时间为6至43个月，平均26个月。入组患者中，有 627 名白人、158 名黑人和 109 名亚裔患者。黑人患者中未经调整的心脏事件（心源性死亡或非致命性心肌梗死）比其他 2 个种族群体更常见（黑人为 12%，白人为 6.4%，亚洲人为 4.0%，P = 0.022）。尽管胰岛素依赖型糖尿病、高血压病史和女性在黑人受试者中最为常见，但在指标事件中进行冠状动脉血管成形术和溶栓治疗的情况是相同的。调整几个协变量后，Cox 分析显示黑人群体与心脏事件显着相关（风险比 6.5，P = .002）。亚组分析显示，教育水平较高的患者（白人为 6.1%，黑人为 5.9%，亚裔为 7.0%，P = 0.94）或专业职业类别的患者（白人为 5.7%，黑人为 4.0%，亚裔为 4.8%，P = 1.0）的事件发生率在 3 个种族中没有差异。结论 黑人心肌梗死后心脏事件发生率增加，较低的社会经济地位可能导致该种族的不良结局。 （Am Heart J 1999；138：500-6。）
Background The role of ethnicity on the long-term outcome after myocardial infarction is not fully understood. Methods and Results We analyzed the data from the Multicenter Study of Myocardial Ischemia in North America and Japan. We enrolled patients after acute myocardial infarction (MI) or unstable angina, with follow-up for 6 to 43 months, an average of 26 months. Among patients enrolled, there were 627 white, 158 black, and 109 Asian patients. Unadjusted cardiac events (cardiac death or nonfatal MI) were more frequent in black patients than in the other 2 ethnic groups (12% in blacks, 6.4% in whites, 4.0% in Asians, P = .022). Although insulin-dependent diabetes, history of hypertension, and female sex were most frequent in black subjects, coronary angioplasty and thrombolysis at index event were done equally. After adjusting for several covariates, Cox analyses revealed that the black group was significantly associated with cardiac events (hazard ratio 6.5, P = .002). Subgroup analyses showed that the event rate among patients who had a higher educational level (6.1% in whites, 5.9% in blacks, and 7.0% in Asian, P = .94) or who were in a professional occupational class (5.7% in whites, 4.0% in blacks, and 4.8% in Asians, P = 1.0) was not different among the 3 ethnic groups. Conclusions Blacks have an increased rate of cardiac events after MI, and a lower socioeconomic status may contribute to the adverse outcome in this ethnic group. (Am Heart J 1999;138:500-6.)