Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (TRIUMPH)

Abstract

Background Black patients with myocardial infarction (MI) have worse outcomes than white patients, including higher mortality, more angina, and worse quality of life. The TRIUMPH study was designed to examine whether racial differences in socioeconomic, clinical, genetic, metabolic, biomarker or treatment characteristics mediate observed disparities in outcomes. Methods and Results Between June 1, 2005 and December 31, 2008, 31567 patients with MI were prospectively screened, 6152 had an eligible MI, and 4340 (71%) were enrolled from 24 US centers. Consenting patients had detailed chart abstractions of their medical history and processes of inpatient care, supplemented with a detailed baseline interview. Detailed genetic and metabolic data were obtained at hospital discharge in 2979 (69%) and 3013 patients (69%), respectively. In a subset of patients, blood and urine samples were obtained at 1-month (obtained in 27% of survivors) and blood samples at 6-months (obtained in 19% of survivors). Centralized follow-up interviews sought to quantify patients’ post-discharge care and outcomes, with a focus on their health status (symptoms, function, and quality of life). At 1, 6 and 12 months, 23%, 27% and 24% were lost to follow-up. Vital status was available for 99% of patients at 12-months. Conclusions TRIUMPH is a novel MI registry with detailed information on patients’ socio-demographic, clinical, treatment, health status, metabolic, and genetic characteristics. The wealth of patient data collected in TRIUMPH will provide unique opportunities to examine factors that may mediate racial differences in mortality and health status after MI and the complex interactions between genetic and environmental determinants of post-MI outcomes.

Variation in Practice Regarding Pretreatment With Dual Antiplatelet Therapy for Patients With Non–ST Elevation Myocardial Infarction

“…Details regarding the TRIUMPH registry have been described previously 16. In brief, TRIUMPH is a large prospective multicenter registry that successively enrolled patients across 24 sites with a diagnosis of AMI from April 2005 through December 2008, a time when there was broad consensus about the importance of DAPT pretreatment.…”

Clinical Relevance of Rehospitalizations for Unstable Angina and Unplanned Revascularization Following Acute Myocardial Infarction

“…TRIUMPH is a prospective multicenter observational registry that enrolled 4340 AMI patients from 24 US medical centers between April 11, 2005, and December 31, 2008 6. Eligible patients were aged ≥18 years with a diagnosis of AMI within 24 hours of admission.…”

The Privilege of Editorship

“…14 Others included a study of frailty and cardiac surgery risk scores, 15 a Markov model projecting cardiovascular risk in China, 16 the TRIUMPH (Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status) methods paper, 17 an assessment of bleeding after undergoing coronary artery bypass surgery, 18 an evaluation of women in randomized trials, 19 a contemporary assessment of hospital performance on the Medicare measures, 20 and a report from Mission: Lifeline on systems of ST-elevation myocardial infarction care. …”