Ethnic Differences in Out-of-Hospital Fatal Pulmonary Embolism

Tang, Yingying; Sampson, Barbara A.; Pack, Stephanie; Shah, Kavisha; Um, Sung Yon; Wang, Dawei; Wang, Tao; Prinz, Mechthild

doi:10.1161/circulationaha.110.976134

Cited by 55 publications

(39 citation statements)

References 32 publications

(27 reference statements)

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“…19 In the United States, AAs exhibit a higher incidence of VTE and mortality rates from the disease compared with populations of European and Asian ancestry. 3,4,39,40 Nonetheless, AAs have a higher percentage of O blood type, which is in the opposite direction of what would be expected. 6,41 Several GWASs have identified polymorphisms in the ABO gene to be associated with risk of VTE among populations of EA [10][11][12] Although not at GWAS For personal use only.…”

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confidence: 77%

Novel genetic predictors of venous thromboembolism risk in African Americans

Hernandez

Gamazon

Smithberger

et al. 2016

Blood

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• Our study has identified common genetic risk factors for VTE among AAs.• These risk factors are associated with decreased thrombomodulin gene expression, suggesting a mechanistic link.Venous thromboembolism (VTE) is the third most common life-threatening cardiovascular condition in the United States, with African Americans (AAs) having a 30% to 60% higher incidence compared with other ethnicities. The mechanisms underlying population differences in the risk of VTE are poorly understood. We conducted the first genome-wide association study in AAs, comprising 578 subjects, followed by replication of highly significant findings in an independent cohort of 159 AA subjects. Logistic regression was used to estimate the association between genetic variants and VTE risk. Through bioinformatics analysis of the top signals, we identified expression quantitative trait loci (eQTLs) in whole blood and investigated the messenger RNA expression differences in VTE cases and controls. We identified and replicated single-nucleotide polymorphisms on chromosome 20 (rs2144940, rs2567617, and rs1998081) that increased risk of VTE by 2.3-fold (P < 6 3 10 27). These risk variants were found in higher frequency among populations of African descent (>20%) compared with other ethnic groups (<10%). We demonstrate that SNPs on chromosome 20 are cis-eQTLs for thrombomodulin (THBD), and the expression of THBD is lower among VTE cases compared with controls (P 5 9.87 3 10 26 ). We have identified novel polymorphisms associated with increased risk of VTE in AAs. These polymorphisms are predominantly found among populations of African descent and are associated with THBD gene expression. Our findings provide new molecular insight into a mechanism regulating VTE susceptibility and identify common genetic variants that increase the risk of VTE in AAs, a population disproportionately affected by this disease. (Blood. 2016;127(15):1923-1929

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confidence: 77%

Novel genetic predictors of venous thromboembolism risk in African Americans

Hernandez

Gamazon

Smithberger

et al. 2016

Blood

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“…Conclusion: Blacks are known to have a higher incidence of deep vein thrombosis (DVT), recurrent DVT, and worse in-hospital and 90-day outcomes from venous thromboembolism (VTE), compared with whites and Hispanics. 17,18 This study provided a rare opportunity to investigate the factors associated with out-of-hospital fatal PE. The racial differences were not fully explained by the investigated clinical factors and genetic tests.…”

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confidence: 99%

Most Important Articles on Cardiovascular Disease Among Racial and Ethnic Minorities

Mody¹,

Gupta²,

Bikdeli³

et al. 2012

Circ: Cardiovascular Quality and Outcomes

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The following are highlights from the new series, Circulation: Cardiovascular Quality and Outcomes Topic Review. This series will summarize the most important manuscripts, as selected by the Editor, that have published in the Circulation portfolio. The objective of this new series is to provide our readership with a timely, comprehensive selection of important papers that are relevant to the quality and outcomes, and general cardiology audience. The studies included in this article represent the most significant research in the area of cardiovascular disease among racial and ethnic minorities. (Circ Cardiovasc Quality and Outcomes. 2012; 5:e33-e41.) S teady improvements have been made in the management of cardiovascular disease over the last decade.1,2 Yet, certain racial and ethnic minority groups have not experienced equivalent improvements in outcomes. For example, although the overall rate of hospitalization for heart failure has declined in recent years, decreases have been lower in blacks compared with whites. 2In addition, mortality related to stroke continues to be higher in blacks.3 There are multiple potential explanations for this heightened cardiovascular risk among minorities, including their higher prevalence of cardiovascular risk factors such as hypertension, diabetes mellitus, and obesity 4 ; the presence of genetic differences predisposing to disease 5 ; differences in socioeconomic factors relating to education, income, language proficiency, and living environments 6 ; and concerning physician attitudes, biases, or frank racism. 3,7 The Institute of Medicine defines "disparities" as "differences in health outcomes that persist when access and patient clinical factors are controlled." 8 In acknowledging the presence of these disparities experienced by racial and ethnic minorities, the American College of Cardiology (ACC) launched the Coalition to Reduce Racial and Ethnic Disparities in Cardiovascular Disease Outcomes (CREDO) alliance and the American Heart Association (AHA) issued a statement highlighting racial differences in stroke care, among other initiatives.9,10 Through these efforts, the ACC and AHA aim to improve physician awareness of racial disparities in cardiovascular disease care, conduct patient education, and provide tools to health systems to help combat inequalities.There is an urgent need for additional information regarding the pathways mediating racial disparities in cardiovascular care, especially those pathways that are amenable to interventions. We have therefore chosen to review a broad range of articles pertinent to racial and ethnic disparities in cardiovascular disease. These include papers examining racial differences in the quality of care provided for patients with myocardial infarction, 11 trends in procedure use for patients with heart failure, 12 survival after heart transplantation, 13 the relative importance of traditional and novel biomarkers of cardiovascular risk, 14 and the influence of socioeconomic factors such as living environment on outcomes. 6 We ...

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“…2 All underwent autopsy, toxicology, microbiology, and genetic testing. Race-adjusted incidence rates per 100 000 people per year were as follows: blacks 3.73, whites, 1.15, and Hispanics, 0.93.…”

Section: Article See P 1502mentioning

confidence: 99%

Race and Venous Thromboembolism

Goldhaber

2014

Circulation

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Ethnic Differences in Out-of-Hospital Fatal Pulmonary Embolism

Cited by 55 publications

References 32 publications

Novel genetic predictors of venous thromboembolism risk in African Americans

Novel genetic predictors of venous thromboembolism risk in African Americans

Most Important Articles on Cardiovascular Disease Among Racial and Ethnic Minorities

Race and Venous Thromboembolism

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