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Differences in incident and recurrent myocardial infarction among White and Black individuals aged 35 to 84: Findings from the ARIC community surveillance study - 02/09/22

Doi : 10.1016/j.ahj.2022.05.020 
Duygu Islek, MD, PhD, MPH a, b, , Alvaro Alonso, MD, PhD a, Wayne Rosamond, PhD c, Anna Kucharska-Newton, PhD, MPH c, Yejin Mok, PhD, MPH d, Kunihiro Matsushita, MD, PhD d, Silvia Koton, PhD d, e, Michael Joseph Blaha, MD, MPH f, Mohammed K Ali, MD, MSc, MBA a, g, h, Amita Manatunga, PhD i, Viola Vaccarino, MD, PhD a, j
a Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 
b Department of Epidemiology, Laney Graduate School, Emory University, Atlanta, GA 
c Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC 
d Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 
e Department of Nursing, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 
f Division of Cardiology, School of Medicine, Johns Hopkins University, Baltimore, MD 
g Emory Global Diabetes Research Center, Hubert Department of Global Health, Emory University, Atlanta, GA 
h Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA 
i Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA 
j Division of Cardiology, School of Medicine, Emory University, Atlanta, GA 

Reprint requests: Duygu Islek, MD, PhD, MPH, Department of Epidemiology, Laney Graduate School, Emory University, 1518 Clifton Road, NE, CNR 3rd Floor, 3060A, Atlanta, GA 30322Department of EpidemiologyLaney Graduate School, Emory University1518 Clifton Road, NE, CNR 3rd Floor, 3060AAtlantaGA30322

Riassunto

Background

No previous study has examined racial differences in recurrent acute myocardial infarction (AMI) in a community population. We aimed to examine racial differences in recurrent AMI risk, along with first AMI risk in a community population.

Methods

The community surveillance of the Atherosclerosis Risk in Communities Study (2005-2014) included 470,000 people 35 to 84 years old in 4 U.S. communities. Hospitalizations for recurrent and first AMI were identified from ICD-9-CM discharge codes. Poisson regression models were used to compare recurrent and first AMI risk ratios between Black and White residents.

Results

Recurrent and first AMI risk per 1,000 persons were 8.8 (95% CI, 8.3-9.2) and 20.7 (95% CI, 20.0-21.4) in Black men, 6.8 (95% CI, 6.5-7.0) and 14.1 (95% CI, 13.8-14.5) in White men, 5.3 (95% CI, 5.0-5.7) and 16.2 (95% CI, 15.6-16.8) in Black women, and 3.1 (95% CI, 3.0-3.3) and 8.8 (95% CI, 8.6-9.0) in White women, respectively. The age-adjusted risk ratios (RR) of recurrent AMI were higher in Black men vs White men (RR, 1.58 95% CI, 1.30-1.92) and Black women vs White women (RR, 2.09 95% CI, 1.64-2.66). The corresponding RRs were slightly lower for first AMI: Black men vs White men, RR, 1.49 (95% CI, 1.30-1.71) and Black women vs White women, RR, 1.65 (95% CI, 1.42-1.92)

Conclusions

Large disparities exist by race for recurrent AMI risk in the community. The magnitude of disparities is stronger for recurrent events than for first events, and particularly among women.

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Graphical abstract




Image, graphical abstract

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Recurrent myocardial infarction, Risk, Myocardial infarction outcomes, Community surveillance, Racial differences, Racial disparities


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© 2022  Pubblicato da Elsevier Masson SAS.
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