Journal of the American Heart Association · 2025
Racial Differences in Recurrent Acute Myocardial Infarction: Findings From the ARIC Cohort.
СтатьяМногоцентровое исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод пока не подготовлен
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Islek Duygu, Alonso Alvaro, Rosamond Wayne, Kucharska-Newton Anna, Mok Yejin, Matsushita Kunihiro, Koton Silvia, Blaha Michael Joseph, Vaccarino Viola
Аннотация
BACKGROUND: We examined racial differences in recurrent nonfatal acute myocardial infarction (AMI) and fatal coronary heart disease (CHD) among ARIC (Atherosclerosis Risk in Communities) cohort participants who survived a first AMI (1987-2017) and assessed whether socioeconomic and cardiovascular risk factors contribute to observed differences.
METHODS: We analyzed 422 Black and 1245 White ARIC participants who survived an incident AMI during follow-up. Incidence rates of recurrent AMI and fatal CHD were calculated by race. Proportional hazards models examined differences after adjustment for socioeconomic and cardiovascular risk factors, with race-sex interactions tested.
RESULTS: The mean±SD age at the time of the first incident AMI was 69.3±9.0 years for Black and 70.7±9.5 years for White participants. The incidence rate per 1000 person-years was higher in Black participants than White participants both for recurrent nonfatal AMI (incidence rate, 32.4 [95% CI, 26.8-38.8] versus 22.8 [95% CI, 20.2-25.6]) and for fatal CHD (34.2 [95% CI, 28.4-40.7] versus 17.9 [95% CI, 15.7-20.4]). In age- and sex-adjusted models, the hazard ratios comparing Black versus White participants were 1.70 (95% CI, 1.36-2.13) for recurrent nonfatal AMI and 2.10 (95% CI, 1.67-2.34) for fatal CHD. The racial differences were statistically not significant after adjustment for socioeconomic and cardiovascular risk factors. There were no significant race and sex interactions for outcomes.
CONCLUSIONS: Black participants have higher rates of recurrent nonfatal AMI and fatal CHD after an initial AMI compared with White participants. These disparities are mostly explained by socioeconomic and cardiovascular risk factors.
METHODS: We analyzed 422 Black and 1245 White ARIC participants who survived an incident AMI during follow-up. Incidence rates of recurrent AMI and fatal CHD were calculated by race. Proportional hazards models examined differences after adjustment for socioeconomic and cardiovascular risk factors, with race-sex interactions tested.
RESULTS: The mean±SD age at the time of the first incident AMI was 69.3±9.0 years for Black and 70.7±9.5 years for White participants. The incidence rate per 1000 person-years was higher in Black participants than White participants both for recurrent nonfatal AMI (incidence rate, 32.4 [95% CI, 26.8-38.8] versus 22.8 [95% CI, 20.2-25.6]) and for fatal CHD (34.2 [95% CI, 28.4-40.7] versus 17.9 [95% CI, 15.7-20.4]). In age- and sex-adjusted models, the hazard ratios comparing Black versus White participants were 1.70 (95% CI, 1.36-2.13) for recurrent nonfatal AMI and 2.10 (95% CI, 1.67-2.34) for fatal CHD. The racial differences were statistically not significant after adjustment for socioeconomic and cardiovascular risk factors. There were no significant race and sex interactions for outcomes.
CONCLUSIONS: Black participants have higher rates of recurrent nonfatal AMI and fatal CHD after an initial AMI compared with White participants. These disparities are mostly explained by socioeconomic and cardiovascular risk factors.