REasons for Geographic And Racial Differences in Stroke- Myocardial Infarction-3

中风-心肌梗死的地理和种族差异的原因-3

• 批准号: 9910226
• 负责人: Emily B Levitan
• 金额: $ 70.26万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9910226
• 关键词: Accelerometer; Address; Age; Ancillary Study; Atrial Fibrillation; Attenuated; Biological Assay; Calibration; Cardiovascular Diseases; Childhood; Cholesterol; Clinical Management; Communities; Coronary; Coronary heart disease; Coupled; Data; Detection; Development; Dietary Practices; Discrimination; Disease Outcome; Elderly; Equation; Evaluation; Event; Food; Frequencies; Funding; Goals; Grant; Health; Health Care Reform; Heart failure; Home visitation; Incidence; Individual; Infrastructure; Institution; International; Intervention; Ischemia; Laboratories; Letters; Light; Link; Medicare; Methods; Modernization; Modification; Morbidity - disease rate; Myocardial Infarction; Observational Study; Occupational; Outcome; Parents; Participant; Patient Outcomes Assessments; Patient Recruitments; Patient-Focused Outcomes; Patients; Phenotype; Population; Population Attributable Risks; Population Study; Populations at Risk; Prevention therapy; Primary Prevention; Procedures; Publications; Publishing; Quality of life; Race; Reasons for Geographic And Racial Differences in Stroke; Recording of previous events; Recurrence; Research; Research Design; Research Personnel; Risk; Risk Factors; Risk stratification; Secondary Prevention; Socioeconomic Status; Stress; Stroke; Subgroup; Survivors; Troponin; adjudicate; adjudication; cardiovascular disorder risk; clinical database; cognitive function; cohort; density; depressive symptoms; follow-up; functional status; health disparity; health management; heart disease prevention; heart disease risk; high risk; high risk population; improved; low socioeconomic status; member; mortality; novel; outcome forecast; patient oriented; population health; prevent; racial disparity; risk prediction model; sex; stroke event; tool

Despite marked declines, coronary heart disease (CHD) remains a leading cause of morbidity and mortality in the US. To further decrease CHD, a better understanding of CHD risks and outcomes in the 21st century is needed in light of: 1) continued health disparities; 2) declining ST elevation myocardial infarctions (MI); 3) increasing sensitivity of troponin laboratory assays, increasing detection of very small and previously undetectable MI events; 4) wide use of statins and revascularization procedures, complicating population studies and risk prediction; 5) more people surviving their first MI; 6) increased emphasis on population health management and patient-centeredness. The REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort includes 30,239 community-dwelling white and black participants recruited in 2003-2007. In the previous 2 funding cycles, the REGARDS-MI ancillary study has produced >100 publications on racial disparities in CHD and identified novel CHD risk factors. The REGARDS parent and other ancillary studies have collected extensive phenotype, cardiovascular disease (CVD) risk factor, and patient-reported outcomes data, including linked Medicare data. A second in-home visit is nearing completion, providing patient-centered endpoints including quality of life up to 10 years following first MI. The availability of these novel data coupled with >10 years of follow-up for all participants offers a unique opportunity to study CHD among high-risk subpopulations, e.g., those with low socioeconomic status (SES), blacks, and older adults to identify strategies to optimize population health while simultaneously eliminating health disparities. Our Specific Aims are to: 1) Determine the 10-year incidence of CHD and CVD (either CHD or stroke) and examine associations with traditional and emerging risk factors. CHD events will be adjudicated using the same rigorous methods used during the first 2 funding periods and combined with stroke events adjudicated through the parent REGARDS study. We will refine published CHD and CVD risk prediction models and assess emerging risk factors in subgroups (e.g., age, race, sex, and SES) and by MI type (very small or `microsize' MI, and type 2 MI). 2) Develop pragmatic strategies to identify high-risk subgroups that could be targeted for interventions to optimize population health while simultaneously eliminating health disparities. We will calculate population attributable risks and numbers of events potentially averted through population shifts in risk factor distributions. 3) Determine the rates of, and risk factors for, recurrent CHD events, heart failure (HF), and mortality after first adjudicated MI (including very small, or `microsize' MI, and type 2 MI) or coronary revascularization procedure, overall, and in subgroups (e.g., type of CHD event, age, race, sex, and SES). 4) Using data from the 2nd in- home visit, describe patient-centered outcomes (functional status, depressive symptoms, stress, cognitive functioning, quality of life), HF, secondary prevention, and risk factor management up to 10 years after first adjudicated MI , overall and in subgroups (e.g., age, race, sex, and SES).

尽管有明显的下降，冠心病（CHD）仍然是美国发病率和死亡率的主要原因

项目成果

Validation of the REGARDS Severe Sepsis Risk Score.

REGARDS 严重败血症风险评分的验证。

• DOI: 10.3390/jcm7120536
• 发表时间: 2018
• 期刊: Journal of clinical medicine
• 影响因子: 3.9
• 作者: Wang,HenryE;Donnelly,JohnP;Yende,Sachin;Levitan,EmilyB;Shapiro,NathanI;Dai,Yuling;Zhao,Hong;Heiss,Gerardo;Odden,Michelle;Newman,Anne;Safford,Monika
• 通讯作者: Safford,Monika

Response to Letter Regarding Article, "Southern Dietary Pattern is Associated With Hazard of Acute Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study".

对有关文章“中风地理和种族差异原因（REGARDS）研究中南方饮食模式与急性冠心病危险相关”的信件的回复。

• DOI: 10.1161/circulationaha.115.020671
• 发表时间: 2016
• 期刊: Circulation
• 影响因子: 37.8
• 作者: Shikany,JamesM;Safford,MonikaM;Newby,PK;Durant,RaeganW;Brown,ToddM;Judd,SuzanneE
• 通讯作者: Judd,SuzanneE

Improving the quality of quality measurement: the tinkerer, the tailor and the candlestick maker.

提高质量测量的质量：修补匠、裁缝和烛台制造商。

• DOI: 10.1097/mlr.0b013e3181a14b65
• 发表时间: 2009
• 期刊: Medical care
• 影响因子: 3
• 作者: Safford,MonikaM

Generalizability of SPRINT Results to the U.S. Adult Population.

• DOI: 10.1016/j.jacc.2015.10.037
• 发表时间: 2016-02-09
• 期刊: Journal of the American College of Cardiology
• 影响因子: 24
• 作者: Bress AP;Tanner RM;Hess R;Colantonio LD;Shimbo D;Muntner P
• 通讯作者: Muntner P

Age and Sex Disparities in Discharge Statin Prescribing in the Stroke Belt: Evidence From the Reasons for Geographic and Racial Differences in Stroke Study.

• DOI: 10.1161/jaha.117.005523
• 发表时间: 2017-08-02
• 期刊: Journal of the American Heart Association
• 影响因子: 5.4
• 作者: Albright KC;Howard VJ;Howard G;Muntner P;Bittner V;Safford MM;Boehme AK;Rhodes JD;Beasley TM;Judd SE;McClure LA;Limdi N;Blackburn J
• 通讯作者: Blackburn J