REGARDS - MI Study

描述（由申请人提供）：背景。至于中风，人们认识到冠心病死亡率的地理和种族差异，但对其了解甚少。NIH （NINDS）支持中风的地理和种族差异原因（REGARDS）研究，该研究跟踪了30,000人（年龄在40 - 44岁之间；1/2非洲裔美国人，1/2欧洲裔美国人；1/2女性；1/2来自中风带/带区）超过3.5年的中风发病率和死亡率。具体的目标。REGARDS-MI辅助研究的总体目标是利用一个狭窄的机会窗口，通过量化冠心病死亡率、发病率（新发和复发住院急性冠心病以及人群院前冠心病死亡）和病死率（急性冠心病患者，28天内死亡）的地理和种族差异来利用REGARD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)研究美国不同地理和种族的冠心病发病率与冠心病危险因素患病率差异的关系；(3)研究美国不同地理和种族的冠心病病死率与社会经济因素、医疗保健和冠心病危险因素的关系。方法。我们将检索REGARDS参与者中所有心脏相关住院病例（约6000例）的医疗记录，并收集所有死亡病例（约500例）的数据。我们将判定冠心病的住院和死亡，收集心脏手术和药物，并将其与REGARDS已经收集的大量数据合并。使用多变量多层次分析，我们将检验10个特定的假设。的影响。这将是第一个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。REGARDS提供了一个独特的机会来实现我们的特定目标，而不需要大量的参与者招募和后续成本，否则将是必要的。REGARDS和REGARDS- mi之间没有预算重叠，因为REGARDS只关注潜在的中风。我们的成果将大大有助于建立知识库，这对实现“2010年健康人”减少健康差距的目标至关重要。

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.