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学科主题: 临床医学
题名:
Comparison of long-term outcomes between older Asian and white patients with non-ST-segment elevation myocardial infarction: Findings from CRUSADE-CMS database
作者: Xu, Weixian1; Holmes, DaJuanicia N.2; Becker, Richard C.2; Roe, Matthew T.2; Peterson, Eric D.2; Wang, Tracy Y.2
刊名: AMERICAN HEART JOURNAL
发表日期: 2013-12-01
DOI: 10.1016/j.ahj.2013.10.001
卷: 166, 期:6, 页:1050-1055
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems
研究领域[WOS]: Cardiovascular System & Cardiology
关键词[WOS]: CORONARY-HEART-DISEASE ; ETHNIC-DIFFERENCES ; MORTALITY ; COHORT ; REGISTRY ; TRIAL
英文摘要:

Background In the United States as well as globally, Asians are a growing proportion of patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI), yet little is known about their longitudinal outcomes.

Methods We linked Centers for Medicare & Medicaid claims data to detailed clinical data for 37,702 NSTEMI patients >= 65 years old treated at 444 CRUSADE hospitals between 2003 and 2006 to examine longitudinal outcomes. We used Cox proportional hazards modeling to compared outcomes between Asian and white patients, adjusting for differences in baseline patient characteristics.

Results Compared with white NSTEMI patients, Asians (n = 307) were younger; more frequently had hypertension, diabetes and renal insufficiency; and were less likely to have had a prior myocardial infarction, but there were no significant differences in rates of cardiac catheterization or revascularization during the index hospitalization between the 2 groups. At 30 days, Asian and white patients had a similar risk-adjusted mortality (9.5% vs 9.9%, P = .77), but by 1 year, Asian patients had a significantly lower risk-adjusted mortality (20.9% vs 24.5%, adjusted hazard ratio 0.64, 95% CI 0.50-0.82). Compared with white patients, Asians also had a lower adjusted 1-year cardiovascular readmission risk (37.1% vs 42.1%, adjusted hazard ratio 0.79, 95% CI 0.64-0.98).

Conclusions Despite similar inhospital treatments, Asian NSTEMI patients had lower mortality and cardiovascular readmission risks at 1 year, compared with white patients. Further study is needed to determine whether intrinsic ethnic differences or differential longitudinal prevention strategies explain these differences in long-term outcomes.

语种: 英语
项目资助者: Astra Zeneca ; Bayer Pharmaceuticals ; BMS ; Daiichi ; Eli Lilly ; Johnson Johnson ; Medicines Company ; Merck ; Momenta Pharmaceuticals ; Regado Biosciences, Inc ; Schering-Plough Research Institute ; Novartis ; Merck-Schering Plough ; Bristol-Myers Squibb ; American College of Cardiology ; American Heart Association ; BMS/Sanofi ; Daiichi Sankyo ; Glaxo Smith Kline ; Gilead Science
WOS记录号: WOS:000327536300016
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/59060
Appears in Collections:北京大学第三临床医学院_期刊论文

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作者单位: 1.Peking Univ, Hosp 3, Beijing 100871, Peoples R China
2.Duke Clin Res Inst, Durham, NC 27705 USA

Recommended Citation:
Xu, Weixian,Holmes, DaJuanicia N.,Becker, Richard C.,et al. Comparison of long-term outcomes between older Asian and white patients with non-ST-segment elevation myocardial infarction: Findings from CRUSADE-CMS database[J]. AMERICAN HEART JOURNAL,2013,166(6):1050-1055.
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