Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction

Graham, Garth; Jones, Philip G.; Chan, Paul S.; Arnold, Suzanne V.; Krumholz, Harlan M.; Spertus, John A.

doi:10.1001/jamanetworkopen.2018.4240

Cited by 67 publications

(53 citation statements)

References 24 publications

(17 reference statements)

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“…In our registry, young women had the lowest SSS of all the groups. Socioeconomic status is a foremost driver of race/ethnic health disparities, and a major determinant of behavioral and clinical risk factors, including smoking and other lifestyle habits, obesity, and diabetes 24,31 . In a combined analysis of two prospective registries, low socioeconomic status had the strongest association with mortality postacute MI independent of race, as compared with other risk factors 32 .…”

Section: Discussionmentioning

confidence: 99%

Outcomes of ST‐elevation myocardial infarction by age and sex in a low‐income urban community: The Montefiore STEMI Registry

Bortnick

Shahid

Shitole

et al. 2020

Clinical Cardiology

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Objectives: To compare outcomes by age and sex in race/ethnic minorities presenting with ST-elevation myocardial infarction (STEMI), as studies are limited. Methods: We studied sociodemographics, management, and outcomes in 1208 STEMI patients evaluated for primary percutaneous coronary intervention between 2008 and 2014 at Montefiore Health System (Bronx, NY). A majority of patients self-identified as nonwhite, and nearly two-thirds were young (<45 years) or middle-aged (45-64 years). Results: Risk factors varied significantly across age groups; with more women and non-Hispanic whites, hypertension, diabetes, dyslipidemia, prior cardiovascular disease, non-sinus rhythm, and collagen vascular disease in the older age group (≥65 years); and higher body mass index, smoking, cocaine use, human immunodeficiency virus (HIV) infection and family history of heart disease in the young. Younger women had lower summary socioeconomic scores than younger men. Middle-aged women had more obesity and dysmetabolism, while men had more heavy alcohol use. There was greater disease severity with increasing age; with higher cardiac biomarkers, 3-vessel disease, cardiogenic shock, and coronary artery bypass grafting. Older patients had higher rates of death and death or readmission over 4.3 (interquartile range 2.4, 6.0) years of follow-up. Middle-aged women had higher rates of death or any readmission than men, but these differences were not significant after adjustment.

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Section: Discussionmentioning

confidence: 99%

Outcomes of ST‐elevation myocardial infarction by age and sex in a low‐income urban community: The Montefiore STEMI Registry

Bortnick

Shahid

Shitole

et al. 2020

Clinical Cardiology

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“…Because socioeconomic factors, including income and insurance, account for a substantial portion of racial differences in health outcomes, 41 Medicare recently modified the HRRP. Starting in fiscal year 2019, performance will be assessed relative to other hospitals that admit similar percentages of patients who are dually eligible for Medicare and Medicaid.…”

Section: Discussionmentioning

confidence: 99%

Thirty-Day Postdischarge Mortality Among Black and White Patients 65 Years and Older in the Medicare Hospital Readmissions Reduction Program

et al. 2019

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Key Points Question In the Medicare Hospital Readmissions Reduction Program, did mortality from all causes increase during the 30 days after hospital discharge among black vs white patients 65 years and older? Findings In a cohort study using a time-series analysis including 3263 acute care hospitals, short-term mortality decreased more among black patients than white patients with acute myocardial infarction. Mortality increased among white patients with heart failure, but trends over time did not differ between black and white patients; and mortality trends over time were stable and similar between black and white patients with pneumonia. Meaning This study suggests that value-based payment policy was not associated with an increase in mortality among black populations, but causes of increasing mortality among white patients warrant investigation.

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“…Issues related to arrhythmias and heart failure development still remain unresolved and socially important in all countries. This is confirmed by statistical data on high risk of mortality due to cardiovascular pathology [1,2]. Considering scientific literature [1,2], authors paid attention to reasonability of stem cells (SCs) use as additional therapy in heart diseases.…”

Section: Introductionmentioning

confidence: 87%

Perineural Migration of Stem Cells in the Model of Damaged Heart Nodes

Vladimir¹

2019

BJSTR

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Unilateral vagotomy (n=15) with simultaneous injection of 10 thousand stem cells in 10µl of culture medium to intact vagus nerve (n=9) was performed on Wistar rats anesthetized with ketamine-xylazine-acepromazine. Migration of stem cells to atriums and ventricles was tracked by fluorescent markers. Also protective role of perineural injection of stem cells was established in relation to development of destructive processes in heart ganglions. Unilateral vagotomy and injection of stem cells to intact vagus nerve resulted in preservation of cell structure in sinoatrial ganglion and recovery of cardiac rhythm. It was assumed that technique of perineural migration of stem cells along vagus nerve fibers to heart is promising for prevention of arrhythmias and heart failure development in patients with impaired heart function.

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Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction

Cited by 67 publications

References 24 publications

Outcomes of ST‐elevation myocardial infarction by age and sex in a low‐income urban community: The Montefiore STEMI Registry

Outcomes of ST‐elevation myocardial infarction by age and sex in a low‐income urban community: The Montefiore STEMI Registry

Thirty-Day Postdischarge Mortality Among Black and White Patients 65 Years and Older in the Medicare Hospital Readmissions Reduction Program

Perineural Migration of Stem Cells in the Model of Damaged Heart Nodes

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