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ABSTRACT: Importance
Black patients experience worse outcomes than white patients following acute myocardial infarction (AMI).Objective
To examine the degree to which nonrace characteristics explain observed survival differences between white patients and black patients following AMI.Design, setting, and participants
This cohort study used the extensive socioeconomic and clinical characteristics from patients recovering from an AMI that were prospectively collected at 31 hospitals across the contiguous United States between 2003 and 2008 for the Prospective Registry Evaluating Myocardial Infarction: Events and Recovery registry and the Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status registry. Survival was assessed using data from the National Death Index. Data were analyzed from December 2016 to July 2018.Main outcomes and measures
Patient characteristics were categorized into 8 domains, and the degree to which each domain discriminated self-identified black patients from white patients was determined by calculating propensity scores associated with black race for each domain as well as cumulatively across all domains. The final propensity score was associated with 1- and 5-year mortality rates.Results
Among 6402 patients (mean [SD] age, 60 [13] years; 2127 [33.2%] female; 1648 [25.7%] black individuals), the 5-year mortality rate following AMI was 28.9% (476 of 1648) for black patients and 18.0% (856 of 4754) for white patients (hazard ratio, 1.72; 95% CI, 1.54-1.92; P?Conclusions and relevanceCharacteristics of black patients and white patients differed significantly at the time of admission for AMI. Those characteristics were associated with an approximately 3-fold difference in 5-year mortality rate following AMI and mediated most of the observed mortality rate difference between the races.
SUBMITTER: Graham GN
PROVIDER: S-EPMC6324589 | biostudies-literature | 2018 Nov
REPOSITORIES: biostudies-literature
JAMA network open 20181102 7
<h4>Importance</h4>Black patients experience worse outcomes than white patients following acute myocardial infarction (AMI).<h4>Objective</h4>To examine the degree to which nonrace characteristics explain observed survival differences between white patients and black patients following AMI.<h4>Design, setting, and participants</h4>This cohort study used the extensive socioeconomic and clinical characteristics from patients recovering from an AMI that were prospectively collected at 31 hospitals ...[more]