Influence of Ethnicity, Age, and Time on Sex Disparities in Long‐Term Cause‐Specific Mortality After Acute Myocardial Infarction

Gao, Fei; Lam, Carolyn S.P.; Yeo, Khung Keong; Machin, David; Carvalho, Leonardo Pinto de; Sim, Ling Ling; Koh, Tian Hai; Foo, David; Ong, Hean Yee; Tong, Khim Leng; Tan, Huay Cheem; Earnest, Arul; Chua, Terrance; Chan, Mark Y.

doi:10.1161/jaha.116.003760

Cited by 10 publications

(4 citation statements)

References 34 publications

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“…In a more recent study by Gao et al, ethnic disparities were found to be wider in 30-day and 10-year CV mortality than non-CV mortality in patients with AMI from 2000 to 2005. 25 Our study complements theirs with the inclusion of analyses on incidence and intermediate 1-year mortality.…”

Section: Discussionmentioning

confidence: 84%

Ethnic Differences and Trends in ST-Segment Elevation Myocardial Infarction Incidence and Mortality in a Multi-Ethnic Population

Zheng

Pek

et al. 2019

Ann Acad Med Singap

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Introduction: This study aimed to compare the incidence and mortality of ST-segment elevation myocardial infarction (STEMI) across the 3 main ethnic groups in Singapore, determine if there is any improvement in trends over the years and postulate the reasons underlying the ethnic disparity. Materials and Methods: This study consisted of 16,983 consecutive STEMI patients who sought treatment from all public hospitals in Singapore from 2007 to 2014. Results: Compared to the Chinese (58 per 100,000 population in 2014), higher STEMI incidence rate was consistently observed in the Malays (114 per 100,000 population) and Indians (126 per 100,000 population). While the incidence rate for the Chinese and Indians remained relatively stable over the years, the incidence rate for the Malays rose slightly. Relative to the Indians (30-day and 1-year all-cause mortality at 9% and 13%, respectively, in 2014), higher 30-day and 1-year all-cause mortality rates were observed in the Chinese (15% and 21%) and Malays (13% and 18%). Besides the Malays having higher adjusted 1-year all-cause mortality, all other ethnic disparities in 30-day and 1-year mortality risk were attenuated after adjusting for demographics, comorbidities and primary percutaneous coronary intervention. Conclusion: It is important to continuously evaluate the effectiveness of existing programmes and practices as the aetiology of STEMI evolves with time, and to strike a balance between prevention and management efforts as well as between improving the outcome of “poorer” and “better” STEMI survivors with finite resources. Key words: Chinese, Indian, Malay, STEMI

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Section: Discussionmentioning

confidence: 84%

Ethnic Differences and Trends in ST-Segment Elevation Myocardial Infarction Incidence and Mortality in a Multi-Ethnic Population

Zheng

Pek

et al. 2019

Ann Acad Med Singap

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“…14 Gao et al suggested that age strongly influenced the association between sex and specific cardiovascular causes of mortality. 15 In the meantime, hemoglobin decline and reduced hematocrit value are the manifestations of anemia, which has high incidence in patients with AMI. 16 In the CADILLAC trial, which evaluated 2082 patients with AMI, approximately 13% of the patients had anemia.…”

Section: Discussionmentioning

confidence: 99%

Correlation of the ORBIT Score With 30-Day Mortality in Patients With ST-Segment Elevation Myocardial Infarction

Shen

Wang

Zheng

et al. 2020

Clin Appl Thromb Hemost

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A new scoring system Outcomes Registry for Better Informed Treatment (ORBIT) score is used to assess the bleeding risk in anticoagulated patients with atrial fibrillation (AF). Our aim is to investigate the possible correlations of the ORBIT score with 30-day mortality in patients with ST-segment elevation myocardial infarction (STEMI). A total of 639 patients with STEMI were enrolled in this study. The ORBIT, HAS-BLED, and TIMI scores were recorded during admission. After 30 days’ follow-up, 639 patients were divided into 2 groups: the survival group and the nonsurvival group. Different clinical parameters were compared. The predictive values of the ORBIT, HAS-BLED, and TIMI scores for 30-day mortality were assessed from receiver operating characteristic (ROC) analyses. The univariate and multivariate Cox proportional hazards analyses were applied to evaluate the relationships between variables and 30-day mortality. Sixty-seven deaths occurred after a 30-day follow-up. The ORBIT, HAS-BLED, and TIMI scores in the death group were higher than those in the survival group ( P < .05). The areas under the ROC curve for the ORBIT, HAS-BLED, and TIMI scores to predict the occurrence of 30-day mortality were 0.811 (95% CI: 0.779-0.841, P < .0001), 0.717 (95% CI: 0.680-0.752, P < .0001), and 0.844 (95% CI: 0.813-0.871, P < .0001), respectively. In multivariate Cox proportional hazards modeling, the high ORBIT score was positively associated with 30-day mortality (hazard ratio: 1.309, 95% CI: 1.101-1.556, P = .013) after adjustment. A graded relation is found in the elevated ORBIT score and 30-day mortality in patients with STEMI. Thus, the ORBIT score can be an independent predictor of 30-day mortality in patients with STEMI.

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“…Our results were also significantly higher than a recent large scale study (wherein the 10-year all-cause mortality rate in Chinese AMI patients was 44.7%). 36 …”

Section: Discussionmentioning

confidence: 99%

Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients

Fu¹,

Yang²,

Shen³

et al. 2018

CIA

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Background and aimsThis study sought to evaluate the prognostic powers of combined use of cystatin C (Cys C) and homocysteine (Hcy) at predicting adverse events of patients >80 years old with acute myocardial infarction (AMI).Patients and methodsThe analysis involved 753 patients >80 years old undergoing coronary angiography for chest pain in China from January 2006 to December 2012. Kaplan–Meier method was used for survival and major adverse cardiac events (MACE) rates. Multivariate Cox regression was performed to identify mortality predictors. Receiver operating characteristic curve analysis was performed to predict the cutoff values of Cys C and Hcy for all-cause mortality.ResultsThe duration of follow-up was 40–116 months (median, 63 months; interquartile range, 51–74 months). The long-term survival and event-free survival rates of AMI patients were significantly lower than those of unstable angina pectoris patients (P<0.05), and were significantly different according to the tertile concentration of Cys C of AMI patients (P<0.01). Cys C and Hcy were independent risk factors for long-term all-cause mortality (odds ratio [OR] =3.72 [2.27–6.09]; OR =1.59 [1.04–2.61]) and MACE (OR =2.83 [1.82–4.40]; OR =1.09 [1.04–1.21]) of AMI patients. The predictive cutoff value of Cys C was 1.815 mg/L (82.8%, 86.4%) and that of Hcy was 15.06 μmol/L (84.4%, 83.1%) in AMI patients. Combined use of both biomarker’s cutoff values further increased the sensitivity and specificity of all-cause mortality.ConclusionCys C is a strong independent predictor of long-term all-cause death and MACE in very old AMI patients. The combined use of Cys C and Hcy further improves the predictive accuracy.

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Influence of Ethnicity, Age, and Time on Sex Disparities in Long‐Term Cause‐Specific Mortality After Acute Myocardial Infarction

Cited by 10 publications

References 34 publications

Ethnic Differences and Trends in ST-Segment Elevation Myocardial Infarction Incidence and Mortality in a Multi-Ethnic Population

Ethnic Differences and Trends in ST-Segment Elevation Myocardial Infarction Incidence and Mortality in a Multi-Ethnic Population

Correlation of the ORBIT Score With 30-Day Mortality in Patients With ST-Segment Elevation Myocardial Infarction

Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients

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