Subclinical myocardial injury and cardiovascular mortality: Racial differences in prevalence and risk (from the third National Health and Nutrition Examination survey)

被引:3
作者
Broughton, Stephen T. [1 ,2 ]
Ahmad, Muhammad [3 ]
Soliman, Elsayed Z. [4 ,5 ]
Magnani, Jared W. [1 ,2 ]
机构
[1] Univ Pittsburgh, Sch Med, Dept Internal Med, Div Cardiol, 3609 Forbes Ave,2nd Floor, Pittsburgh, PA 15261 USA
[2] Univ Pittsburgh, Med Ctr, Inst Heart & Vasc, 3609 Forbes Ave,2nd Floor, Pittsburgh, PA 15261 USA
[3] Wake Forest Sch Med, Dept Internal Med, Winston Salem, NC USA
[4] Wake Forest Sch Med, Cardiol Sect, Winston Salem, NC 27101 USA
[5] Wake Forest Sch Med, Dept Epidemiol & Prevent, Epidemiol Cardiol Res Ctr EPI CARE, Winston Salem, NC 27101 USA
关键词
cardiovascular mortality; NHANES; racial differences; subclinical myocardial injury; SCORE; DISPARITIES; DISEASE; MEN;
D O I
10.1111/anec.12827
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Subclinical myocardial injury (SCMI) determined from the Electrocardiographic Cardiac Infarction/Injury Score (CIIS) is associated with increased risk of cardiovascular disease and mortality. We hypothesized that SCMI prevalence and association with mortality would differ by race, categorized as non-Hispanic White (White), non-Hispanic Black (Black), and Mexican American. Methods Our analysis included 5,852 participants (age 58.5 +/- 13.2 years; 54% women, 52% Whites, 23% Blacks, and 25% Mexican American participants) from the National Health and Nutrition Examination Survey (NHANES III, 1988-94) who were free of cardiovascular disease at the time of enrollment. SCMI was defined as the presence of CIIS >= 10 score points on the 12-lead ECG. Prevalence of SCMI and its association with cardiovascular mortality were examined in each race/ethnic group in models adjusted for sociodemographics and common cardiovascular risk factors. Results SCMI prevalence was 23.4% in Whites, 21.8% in Blacks, and 18.0% in Mexican Americans. Compared to Whites, Blacks were as likely to have SCMI (odds ratio [OR] 0.95, 95% confidence interval [CI] 0.80-1.13), while Mexican Americans were less likely (OR 0.74, 95% CI 0.62-0.88). SCMI was not associated with increased risk of cardiovascular mortality in either Whites (hazard ratio [HR] 1.18, 95% CI 0.95-1.48) or Blacks (HR 1.19, 95% CI 0.79-1.80). In contrast, SCMI in Mexican Americans was associated with increased risk of cardiovascular mortality (HR 1.74, 95% CI 1.13-2.67, p < .05). Conclusion Mexican Americans had a lower prevalence of SCMI, but increased risk of cardiovascular mortality. Screening for SCMI may identify individuals at increased risk and improve targeted prevention efforts.
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