scholarly journals Ethnic Disparity in Mortality Among Ischemic Heart Disease Patients. A-20 Years Outcome Study From Israel

2021 ◽  
Vol 8 ◽  
Author(s):  
Arsalan Abu-Much ◽  
Eyal Nof ◽  
Nicola Luigi Bragazzi ◽  
Anan Younis ◽  
David Hochstein ◽  
...  

Background: Long-term morbidity and mortality data among ischemic heart disease (IHD) patients of different ethnicities are conflicting. We sought to determine the independent association of ethnicity and all-cause mortality over two decades of follow-up of Israeli patients.Methods: Our study comprised 15,524 patients including 958 (6%) Arab patients who had been previously enrolled in the Bezafibrate Infarction Prevention (BIP) registry between February 1, 1990, and October 31, 1992, and subsequently followed-up for long-term mortality. We compared clinical characteristics and outcomes of Israeli Arabs and Jews. Propensity score matching (PSM) (1:2 ratios) was used for validation.Results: Arab patients were significantly younger (56 ± 7 years vs. 60 ± 7 years; p < 0.001; respectively), and had more cardiovascular disease (CVD) risk factors. Kaplan-Meier survival analysis showed that all-cause mortality was significantly higher among Arab patients (67 vs. 61%; log-rank p < 0.001). Multivariate adjusted analysis showed that mortality risk was 49% greater (HR 1.49; 95% CI: 1.37–1.62; p < 0.001) among Arabs.Conclusions: Arab ethnicity is independently associated with an increased 20-year all-cause mortality among patients with established IHD.

Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 357
Author(s):  
Radisauskas ◽  
Kirvaitiene ◽  
Bernotiene ◽  
Virviciutė ◽  
Ustinaviciene ◽  
...  

Background and Objective: There is a lack of reliable epidemiological data on the long-term survival after acute myocardial infarction (AMI) in the Lithuanian population. The aim of the study was to evaluate the long-term (36 months) survival after AMI among persons aged 25–64 years, who had experienced AMI in four time-periods 1996, 2003–2004, 2008, and 2012. Material and Methods: The source of the data was Kaunas population-based Ischemic heart disease (IHD) register. Long-term survival after AMI (36 months) was evaluated using the Kaplan–Meier method. The survival curves significantly differed when p < 0.05. Hazard ratio for all-cause mortality and their 95% CIs, adjusted for baseline characteristics, were estimated with the Cox proportional hazards regression model. Results: The analysis of data on 36 months long-term survival among Kaunas population by sex and age groups showed that the survival rates among men and women were 83.4% and 87.6%, respectively (p < 0.05) and among 25–54 years-old and 55–64 years-old persons, 89.2% and 81.7%, respectively (p < 0.05). The rates of long-term survival of post-AMI Kaunas population were better in past periods than in first period. According to the data of the Kaplan-Meier survival analysis, long-term survival of 25 to 64-year-old post-AMI Kaunas population was without significantly difference in 1996, 2003–2004, 2008 and 2012 (Log-rank = 6.736, p = 0.081). The adjusted risk of all-cause mortality during 36 months among men and 25 to 54-year-old patients was on the average by 35% and 60% lower in 2012 than in 1996, respectively. Conclusion: It was found that 36 months survival post MI among women and younger (25–54 years) persons was significant better compared to men and older (55–64 years) persons. Long-term survival among 55 to 64-year-old post-AMI Kaunas population had a tendency to decrease during last period, while among 25–54 years old persons long-term survival was without significant changes. The results highlight the fact that AMI survivors, especially in youngest age, remain a high-risk group and reinforce the importance of primary and secondary prevention for the improvement of long-term prognosis of AMI patients.


2016 ◽  
Vol 62 (4) ◽  
pp. 593-604 ◽  
Author(s):  
Anne-Marie K Jepsen ◽  
Anne Langsted ◽  
Anette Varbo ◽  
Lia E Bang ◽  
Pia R Kamstrup ◽  
...  

Abstract BACKGROUND Increased concentrations of remnant cholesterol are causally associated with increased risk of ischemic heart disease. We tested the hypothesis that increased remnant cholesterol is a risk factor for all-cause mortality in patients with ischemic heart disease. METHODS We included 5414 Danish patients diagnosed with ischemic heart disease. Patients on statins were not excluded. Calculated remnant cholesterol was nonfasting total cholesterol minus LDL and HDL cholesterol. During 35836 person-years of follow-up, 1319 patients died. RESULTS We examined both calculated and directly measured remnant cholesterol; importantly, however, measured remnant cholesterol made up only 9% of calculated remnant cholesterol at nonfasting triglyceride concentrations &lt;1 mmol/L (89 mg/dL) and only 43% at triglycerides &gt;5 mmol/L (443 mg/dL). Multivariable-adjusted hazard ratios for all-cause mortality compared with patients with calculated remnant cholesterol concentrations in the 0 to 60th percentiles were 1.2 (95% CI, 1.1–1.4) for patients in the 61st to 80th percentiles, 1.3 (1.1–1.5) for the 81st to 90th percentiles, 1.5 (1.1–1.8) for the 91st to 95th percentiles, and 1.6 (1.2–2.0) for patients in the 96th to 100th percentiles (trend, P &lt; 0.001). Corresponding values for measured remnant cholesterol were 1.0 (0.8–1.1), 1.2 (1.0–1.4), 1.1 (0.9–1.5), and 1.3 (1.1–1.7) (trend, P = 0.006), and for measured LDL cholesterol 1.0 (0.9–1.1), 1.0 (0.8–1.2), 1.0 (0.8–1.3), and 1.1 (0.8–1.4) (trend, P = 0.88). Cumulative survival was reduced in patients with calculated remnant cholesterol ≥1 mmol/L (39 mg/dL) vs &lt;1 mmol/L [log-rank, P = 9 × 10−6; hazard ratio 1.3 (1.2–1.5)], but not in patients with measured LDL cholesterol ≥3 mmol/L (116 mg/dL) vs &lt;3 mmol/L [P = 0.76; hazard ratio 1.0 (0.9–1.1)]. CONCLUSIONS Increased concentrations of both calculated and measured remnant cholesterol were associated with increased all-cause mortality in patients with ischemic heart disease, which was not the case for increased concentrations of measured LDL cholesterol. This suggests that increased concentrations of remnant cholesterol explain part of the residual risk of all-cause mortality in patients with ischemic heart disease.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Imaoka ◽  
N Umemoto ◽  
S Oshima

Abstract Background In clinical setting, ischemic heart disease is a challenging problem in hemodialysis (HD) population. Coronary flow reserve (CFR) measured by 13 ammonia positron emitting tomography (13NH3PET) is an established and reliable modality for detecting coronary artery disease. Furthermore, some prior studies show CFR is an important and independent predictor for cardiovascular event and mortality. On the other hand, HD patients with malnutrition status have poor prognosis. We have reported about the relationship between cardiovascular events and geriatric nutrition risk index (GNRI). Now, we wonder the predictability of combination of CFR and GNRI. Methods and result We collected 438 consecutive HD patients who received 13NH3PET in our hospital suspected for ischemic heart disease. 29 patients were excluded due to undergoing coronary revascularization within 60 days, 103 patients were excluded due to incomplete database. In total, 306 HD patients were classified into 4 group according the median value of CFR (1.99) and GNRI (97.73); Low CFR Low GNRI group (n=77), High CFR and Low GNRI group (n=76), Low CFR High GNRI group (n=78) and High CFR High GNRI group (n=75). We collected their follow up data up to 1544 days (median 833 days) about all-cause mortality and cardiovascular (CV) mortality. Surprisingly, there is no mortality event in High CFR High GNRI group. We analyzed about all-cause mortality, CV mortality. Kaplan-Meyer analysis shows there are statistically intergroup differences in each (all-cause mortality; log rank p&lt;0.01, CV mortality; log rank p=0.02). Furthermore, we calculated area under the curve (AUC) analysis, net reclassification improvement (NRI) and integrated discrimination improvement (IDI)m adding GNRI and CFR on conventional risk factors. There are intergroup differences for all-cause mortality in AUC [conventional risk factors, +GNRI, +GNRI+CFR; 0.70, 0.72 (p=0.29), 0.79 (p&lt;0.01)], NRI [+GNRI; 0.32 (p=0.04), +GNRI+CFR 0.82 (p&lt;0.01)] and IDI [+GNRI; 0.01 (p=0.05), +GNRI+CFR 0.09 (p&lt;0.01)]. Conclusion HD patients with low CFR and malnutrition status has statistically significant poorer prognosis comparing HD patients with high CFR and without malnutrition status. Adding combination of GNRI and CFR on conventional risk factors improves the predictability of HD population's prognosis. Funding Acknowledgement Type of funding source: None


2005 ◽  
Vol 182 (2) ◽  
pp. 315-321 ◽  
Author(s):  
Annie C. St-Pierre ◽  
Bernard Cantin ◽  
Jean Bergeron ◽  
Matteo Pirro ◽  
Gilles R. Dagenais ◽  
...  

2016 ◽  
Vol 25 (10) ◽  
pp. 2526-2534 ◽  
Author(s):  
Michał Kuzemczak ◽  
Paulina Białek-Ławniczak ◽  
Katarzyna Torzyńska ◽  
Agnieszka Janowska-Kulińska ◽  
Izabela Miechowicz ◽  
...  

2015 ◽  
Vol 373 (20) ◽  
pp. 1937-1946 ◽  
Author(s):  
Steven P. Sedlis ◽  
Pamela M. Hartigan ◽  
Koon K. Teo ◽  
David J. Maron ◽  
John A. Spertus ◽  
...  

1989 ◽  
Vol 84 (1) ◽  
pp. 157-162 ◽  
Author(s):  
H. Pouleur ◽  
C. Eyll ◽  
J. Etienne ◽  
H. Mechelen ◽  
A. Vuylsteke ◽  
...  

2011 ◽  
Vol 1 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Abdullah M. Krawagh ◽  
Abdullah M. Alzahrani ◽  
Tariq A. Naser

This study addresses the prevalence of ischemic heart disease, hypertension and long-term complications of diabetes mellitus among patients attending the diabetic clinic and their relation to glycemic control. Methods: A study was conducted on a cross-section on all consecutive patients attending the diabetic clinic at King Khalid National Guard Hospital in Jeddah, Saudi Arabia, from January 2007 to January 2008. The degree of glycemic control was gauged using blood level of glycosylated hemoglobin (HbA1C) and classified into good (less 7%), fair (7.1-8%), poor (8.1-9%) and very poor (greater than 9%). All patients were screened for hypertension, ischemic heart disease and microvascular complications. Results: Two hundred and ten patients were recruited in the study. Glycemic control was good in 17 (8.1%), fair in 49 (23.2%), poor in 56 (26.6%) and very poor in 88 (41.9%). There was high prevalence of retinopathy (76; 36%), microalbuminuria (80; 37.9%), neuropathy (108; 51.2%) and ischemic heart disease (51; 24.2%), especially among patients with poor and very poor control. Although the presence of hypertension, frank nephropathy and peripheral vascular disease was also disturbingly high among diabetic patients, their frequency was the same among good, fair, poor and very poor glycemic control groups. Conclusion: The prevalence of long-term complications of diabetes mellitus was alarmingly high among Saudi nationals. Microvascular complications and ischemic heart disease were also noticed to be more common in diabetics with poor and very poor glycemic control. This emphasizes the need of national awareness program about the gravity of the problem.


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