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Racial disparity in long-term mortality rate after hospitalization for myocardial infarction: the Atherosclerosis Risk in Communities study.

TitleRacial disparity in long-term mortality rate after hospitalization for myocardial infarction: the Atherosclerosis Risk in Communities study.
Publication TypeJournal Article
Year of Publication2003
AuthorsDing J, Diez Roux AV, Nieto JF, McNamara RL, Hetmanski JB, Taylor HA, Tyroler HA
JournalAm Heart J
Volume146
Issue3
Pagination459-64
Date Published2003 Sep
ISSN1097-6744
KeywordsAfrican Americans, Age Factors, European Continental Ancestry Group, Female, Hospitalization, Humans, Incidence, Male, Middle Aged, Myocardial Infarction, Proportional Hazards Models, Prospective Studies, Risk Factors, Sex Factors, Socioeconomic Factors, United States
Abstract

BACKGROUND: The underlying reasons why African American patients have a significantly higher mortality rate than European American patients after a myocardial infarction (MI) remain unclear. This study examined the racial disparity in mortality rates after MI and possible explanatory factors.

METHODS: A prospective analysis was conducted within the Atherosclerosis Risk in Communities (ARIC) study, a community-based study of 15,792 middle-aged adults. From 1987 to 1998, 642 patients (471 European American and 171 African American) hospitalized for MI without prior history of MI were identified. Of these 642 patients, 129 (82 European American and 47 African American) died during follow-up.

RESULTS: Cox proportional hazard models were used to analyze the racial difference in mortality rate after MI. After adjusting for age and sex, the relative hazard (RH) comparing African American patients to European American patients was 1.80 (95% CI, 1.24-2.61). The RH decreased after adjusting for vascular risk factors (1.29; 95% CI, 0.83-2.00), socioeconomic position (1.31; 95% CI, 0.83-2.09), severity of MI (1.60; 95% CI, 1.05-2.45), and treatment (1.36; 95% CI, 0.92-2.00). In the final model, which included all factors aforementioned, the RH for race was 1.00 (95% CI, 0.56-1.77).

CONCLUSIONS: Our findings suggested that vascular risk factors, socioeconomic position, and treatment play major roles in the racial disparity in mortality rate after MI.

DOI10.1016/S0002-8703(03)00228-X
Alternate JournalAm Heart J
PubMed ID12947363
Grant ListN01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States