Abstract:
BACKGROUND:The impact of race and sex on clinical outcomes after percutaneous coronary interventions remains incompletely understood. Specific data on patient demographics, lesion characteristics, and outcomes of black versus white patients are poorly described. To further evaluate these issues, we analyzed the New Approaches in Coronary Interventions (NACI) registry. METHODS:Patients (200 black, 4279 white) undergoing coronary interventions in the NACI trial were compared. A Cox proportional hazards model was used to determine which baseline demographics were independent risk factors for the combined end point of death, Q-wave myocardial infarction, and coronary artery bypass grafting at 1 year. RESULTS:Black patients were significantly younger (age 59 +/- 11 vs 63 +/- 11 years; P <.001), more often obese (29.6 +/- 6 vs 27.5 +/- 4.8 kg/m(2); P <.001), female (50% vs 34%; P <.001), diabetic (34% vs 21%; P <.001), and hypertensive (71% vs 52%; P <.001). Black patients were significantly more likely to have single-vessel disease (48% vs 40%; P <.05) and less likely to have undergone coronary artery bypass grafting (26% vs 34%; P <.05). Blacks were significantly more likely to have a discrete lesion (85% vs 62%; P <. 001) with less thrombus (7% vs 12%; P <.05), tortuosity (17% vs 25%; P <.05), and an ulcerated appearance (5% vs 10%; P <.05). Despite these significant baseline differences, no significant difference was seen in the procedural success (80% vs 82%) or major adverse events (death, Q-wave myocardial infarction, any revascularization) at 1 year (39% vs 34%). Predictors of adverse events for white patients included diabetes (relative risk [RR] = 1.24; confidence intervals [CI], 1.0-1.5) and high-risk status (RR = 1.58; CI, 1.26-1. 91). Predictive characteristics of adverse events for black patients included only sex (RR = 3.45; CI, 1.27-9.35; P =.02). CONCLUSIONS:There are significant differences in baseline characteristics of black patients compared with white patients. Despite these differences in traditional risk factors, they do not affect procedural success or 1-year outcome. In black patients, only sex predicted adverse events. Additional investigation is required to understand the mechanisms for this difference.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Marks DS,Mensah GA,Kennard ED,Detre K,Holmes DR Jrdoi
10.1067/mhj.2000.106645subject
Has Abstractpub_date
2000-07-01 00:00:00pages
162-9issue
1eissn
0002-8703issn
1097-6744pii
S0002-8703(00)63301-Xjournal_volume
140pub_type
杂志文章abstract::We aimed to investigate long-term (≥5 years) outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) using a meta-analysis from updated published randomized trials. Our data showed that the risk of all-cause death as well as cardi...
journal_title:American heart journal
pub_type: 信件,meta分析
doi:10.1016/j.ahj.2020.06.001
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Stroke in patients with heart failure is associated with poor outcomes. Risk stratification schemes may improve clinical decision making in this patient population. This study investigated whether female sex is a risk factor for stroke in patients with heart failure in sinus rhythm. METHODS:This is a popula...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2014.12.004
更新日期:2015-03-01 00:00:00
abstract::Sixteen patients with mild or moderate essential hypertension received 1 to 8 mg/day of doxazosin (mean daily dose, 2.7 mg). Blood pressure reduction (supine and standing) was highly significant (p less than 0.001), and no significant changes in heart rate were observed. A significant reduction (p less than 0.01) in l...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(91)90871-e
更新日期:1991-01-01 00:00:00
abstract::CHD remains the leading cause of death in most developed countries; therefore, elucidation of risk factors and associated mechanisms for atherosclerosis and development of CHD has been a high priority. Data from the Framingham Heart Study and other large-scale epidemiologic studies have identified major risk factors a...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(96)90096-4
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Little data exist to assist to help those organizing and managing heart failure (HF) disease management (DM) programs. We aimed to describe the intensity of outpatient HF care (clinic visits and telephone calls) and medical and nonpharmacological interventions in the outpatient setting. METHODS:This was a p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.12.026
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to assess incidence and risk factors for severe renal dysfunction in patients requiring oral anticoagulation to help guide initial drug choice and provide a rational basis for interval monitoring of renal function for patients prescribed non-vitamin K oral anticoagulants. METHOD...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.08.017
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Race-ethnic differences exist in the epidemiology of heart failure, with blacks experiencing higher incidence and worse prognosis. Left ventricular (LV) systolic dysfunction (LVSD) detected by speckle-tracking global longitudinal strain (GLS) is a predictor of cardiovascular events including heart failure. I...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2015.02.011
更新日期:2015-05-01 00:00:00
abstract::The effect of the reperfusion on myocardial infarction has been studied in the rat in order to assess the possible reversibility of myocardial damage. The present study deals with reperfusion of experimental myocardial infarction in the rat. Two groups of animals were compared: one was subjected to permanent ischemia ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80255-x
更新日期:1977-03-01 00:00:00
abstract::A prospective study examining the relationship between psychological distress and ventricular ectopy was conducted with 125 post-myocardial infarction patients equipped with a transtelephonic ECG monitor. Subjects were subsequently grouped according to the occurrence (n = 59) or nonoccurrence (n = 65) of ventricular a...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(88)90246-3
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Neonates with critical pulmonary valve stenosis often demonstrate small or hypoplastic right ventricular structures. Relief of the obstruction enhances forward flow across the right ventricle and reduces its pressure load. Growth of the right ventricle and especially of the pulmonary valve annulus was evalua...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1053/hj.1998.v136.89576
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Kidney failure causes anemia and is associated with a very high risk of coronary heart disease (CHD). Mildly to moderately decreased kidney function is far more common and also is associated with an elevated prevalence of anemia and CHD risk. Recent data suggest an even higher risk of CHD when both condition...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.03.055
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:CSL112 (apolipoprotein A-I [human]) is a plasma-derived apolipoprotein A-I developed for early reduction of cardiovascular risk following an acute myocardial infarction (AMI). The safety of CSL112 among AMI subjects with moderate, stage 3 chronic kidney disease (CKD) is unknown. METHODS:CSL112_2001, a multi...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2018.11.008
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:We investigated the role of the renin-angiotensin system in women with signs and symptoms of ischemia without obstructive coronary artery disease (CAD). Although microvascular dysfunction has been suggested to explain this syndrome and recently was found to predict adverse outcomes, the mechanisms and treatm...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2011.07.011
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:We compared efficacy and safety of short- (3 or 6 months) versus long-term (≥12 months) dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation, according to the presence of chronic kidney disease (CKD). METHODS:Patient-level pooled analysis was performed with 7242 patients (87.2% with ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2017.11.013
更新日期:2018-03-01 00:00:00
abstract::The effects of handgrip and supine bicycle exercise on hemodynamics and left ventricular (LV) performance were compared in 25 patients with moderate to severe aortic regurgitation (AR) and normal LV ejection fraction at rest (greater than or equal to 50%) and in 10 control subjects. In both groups, heart rate, systoli...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90355-2
更新日期:1985-06-01 00:00:00
abstract::Three hundred post infarction participants who had received type A behavioral counseling in the Recurrent Coronary Prevention Project, (RCPP) agreed to be followed for 1 additional year after stopping 4.5 years of continuous type A behavioral counseling. One hundred fourteen participants who had served for 4.5 years a...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(87)90742-3
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:Achieving a therapeutic international normalized ratio (INR) before hospital discharge is an important inpatient goal for patients undergoing mechanical cardiac valve replacement (MCVR). The use of clinical algorithms has reduced the time to achieve therapeutic INR (TTI) with warfarin therapy. Whether TTI pr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.02.011
更新日期:2017-05-01 00:00:00
abstract::The incidence and prognosis of acute coronary reocclusion occurring after patients had left the catheterization laboratory following a successful percutaneous transluminal coronary angioplasty (PTCA) procedure and the temporal relation of this event to the discontinuation of systemic heparin administration were analyz...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90326-2
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:We assessed left atrial function in normal subjects and in patients with hypertrophic cardiomyopathy (HCM) by using Doppler echocardiography at the supine position and after sudden standing. METHODS AND RESULTS:Twenty-seven patients with hypertrophic obstructive cardiomyopathy (HOCM), 17 patients with HCM, ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70153-x
更新日期:1998-12-01 00:00:00
abstract::Late potentials have been shown to predict malignant ventricular arrhythmias and sudden cardiac death. To determine whether prolonged, strenuous activity is associated with the development of ventricular late potentials, signal-averaged electrocardiography was performed on 30 marathon runners before, immediately after...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90010-0
更新日期:1989-12-01 00:00:00
abstract::The objective of this investigation was to assess the acute and long-term outcome after coronary angioplasty in patients undergoing chronic hemodialysis. Previous studies have suggested a high incidence of restenosis after coronary angioplasty performed in patients with renal failure. Medical discharge abstracts for 8...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90476-6
更新日期:1994-08-01 00:00:00
abstract::While sudden death after acute myocardial infarction or ischemia most commonly occurs in the first few minutes, usually from tachyarrhythmias, little is known of associated hemodynamics. We monitored hemodynamics for 15 minutes following coronary embolization with mercury in 31 awake dogs. In 17 nonsurvivors, mean art...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90131-9
更新日期:1981-04-01 00:00:00
abstract:BACKGROUND:In the United States, there continues to be debate about whether certain types of hospitals deliver improved patient outcomes. We sought to assess the association between hospital organizational characteristics and in-hospital outcomes for percutaneous coronary intervention (PCI). METHODS:Retrospective anal...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2011.10.010
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus is an increasingly prevalent condition among heart failure (HF) patients. The long-term morbidity and mortality among patients with and without diabetes with HF with reduced (HFrEF), borderline (HFbEF), and preserved ejection fraction (HFpEF) are not well described. METHODS:Using the Get W...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2019.01.006
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:Racial differences in cardiovascular mortality among women remain largely unexplained. Preliminary data suggest that African American and Caucasian differences in endothelial function may parallel differential cardiovascular disease (CVD) risk in women. To further study differences in endothelial function bet...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.04.032
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:The activated coagulation time (ACT) is a rapid measurement of a patient's level of heparin anticoagulation during cardiac catheterization. Patients receiving warfarin therapy occasionally are seen at the catheterization laboratory for emergent procedures. The effects of warfarin on ACT activity have not bee...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70223-6
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Knowledge of pressure gradients across valves, arteries, and ventricular septal defects (VSD) is important in patient management. It was determined how well such gradients can be estimated by auscultation of a murmur's frequencies. METHODS:In 151 patients with pulmonary stenosis (PS) (n = 77), aortic stenos...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.113222
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Little is known about the management of elderly patients with congestive heart failure (CHF) although they represent the majority of the CHF population. Therefore, the TIME-CHF study was set up (1) to evaluate the medical management of very old patients (> or = 75 years) with CHF compared with younger patien...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2005.10.022
更新日期:2006-05-01 00:00:00
abstract::Right ventricular myocardial infarction has been reported to occur exclusively in association with inferior left ventricular infarction. To determine the frequency of right ventricular myocardial infarction in association with anterior left ventricular myocardial infarction, all hearts with anterior myocardial infarct...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90004-4
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:In the United States as well as globally, Asians are a growing proportion of patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI), yet little is known about their longitudinal outcomes. METHODS:We linked Centers for Medicare & Medicaid claims data to detailed clinical data for 37...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.10.001
更新日期:2013-12-01 00:00:00