REGARDS - MI Study

简介(申请人提供)：背景。至于中风，冠心病死亡率的地理和种族差异是公认的，但了解很少。NIH(NINDS)支持中风中地理和种族差异的原因(CONTS)研究，跟踪调查30,000人(年龄44岁；1/2非裔美国人，1/2欧洲裔美国人；1/2女性；1/2来自中风带/扣区)，超过3.5年的中风发病率和死亡率。明确的目标。AGINS-MI辅助研究的总体目标是利用狭窄的机会窗口，通过量化CHD死亡率、发病率(人口中新发和反复住院的急性CHD和院前死亡)和病死率(在发生急性CHD事件的人中，28天内死亡)的地理和种族差异，利用AGINS的基础设施。我们的具体目标是(1)估计美国特定地理和种族的冠心病死亡率、发病率和病死率；(2)研究美国特定地理和种族的发病率与冠心病风险因素患病率的关系；以及(3)研究美国特定地理和种族的冠心病病例死亡率与社会经济因素、医疗保健和冠心病风险因素的关系。方法：研究方法。我们将检索所有与心脏相关的住院患者的医疗记录(约6000例)，并收集所有死亡病例的数据(约500例)。我们将裁决CHD的住院和死亡人数，收集心脏手术和药物，并将其与CONTS已经收集的大量数据合并。使用多变量多水平分析，我们将检验10个具体的假设。这意味着什么。这将是第一项将冠心病发病率和病死率(包括院前死亡)与冠心病死亡率的地理和种族差异联系起来的全国性研究。ATERS为实现我们的具体目标提供了一个独特的机会，而不需要大量招募参与者和支付后续费用，否则将是必要的。在关注和关注之间没有预算重叠-MI只关注潜在的中风。我们的成果将为实现2010年减少健康差距的健康人目标所必需的知识基础作出重大贡献。

DESCRIPTION (provided by applicant): BACKGROUND. As for stroke, geographic and ethnic variations in CHD mortality are recognized but poorly understood. NIH (NINDS) supported the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study to follow 30,000 individuals (age >44; 1/2 African American, 1/2 European American; 1/2 female; 1/2 from the stroke belt/ buckle areas) over 3.5 years for stroke incidence and mortality. SPECIFIC AIMS. The overall goal of the REGARDS-MI Ancillary Study is to capitalize on a narrow window of opportunity to leverage REGARD'S infrastructure by quantifying geographic and ethnic variations in CHD mortality, attack rates (new and recurrent hospitalized acute CHD and pre-hospital CHD death in the population) and case fatality (among those with an acute CHD event, death within 28 days). Our Specific Aims are to (1) estimate US geographic- and ethnic-specific rates of CHD mortality, attack rates, and case fatality; (2) study the relationship between US geographic- and ethnic-specific attack rates and variation in the prevalence of CHD risk factors; and (3) study the relationship between US geographic- and ethnic-specific CHD case fatality and socioeconomic factors, medical care and CHD risk factors. METHODS. We will retrieve medical records for all heart-related hospitalizations (about 6000) among REGARDS participants and collect data on all deaths (about 500). We will adjudicate hospitalizations and deaths for CHD, collect cardiac procedures and medications, and merge this with extensive data already being collected by REGARDS. Using multivariable multi-level analyses, we will test 10 specific hypotheses. IMPLICATIONS. This will be the first nationwide study to relate CHD attack rate and case fatality, including pre-hospital deaths, to geographic and ethnic variations in CHD mortality. REGARDS offers a unique opportunity to attain our specific aims without the massive participant recruitment and follow-up costs that otherwise would be necessary. There is no budgetary overlap between REGARDS and REGARDS-MI as REGARDS focuses only on potential strokes. Our results will contribute significantly to the knowledge base essential for attaining the Healthy People 2010 goal of reducing health disparities.