Black adults had a higher unadjusted risk of post-MI CVD events than White adults (HR 1.42; 95% CI 1.17-1.71), which was attenuated after adjusting for pre-MI health and MI characteristics (HR 1.01).
Cohort (n=1,122)
Yes
Does Black race compared to White race increase the risk of subsequent CVD events and mortality after myocardial infarction?
Higher post-MI cardiovascular event rates in Black compared to White adults are largely explained by differences in pre-MI health status and MI characteristics rather than race itself.
Effect estimate: HR 1.42 (95% CI 1.17-1.71)
BACKGROUND: Despite improvements in prognosis following myocardial infarction (MI), racial disparities persist. The objective of this study was to examine disparities between Black and White adults in cardiovascular disease (CVD), coronary heart disease, stroke, heart failure (HF), and mortality after MI and characteristics that may explain the disparities. METHODS: This prospective cohort study included 1122 REGARDS (Reasons for Geographic and Racial Differences in Stroke) study participants with incident MI between 2003 and 2016. We followed participants for subsequent CVD events (MI, stroke, HF hospitalization, or death from CVD; n=431), coronary heart disease events (MI or death from coronary heart disease; (n=277), stroke (n=68), HF events (HF hospitalization or death from HF; n=191), and all-cause mortality (n=527; 3-year median follow-up after MI). RESULTS: Among 1122 participants with incident MI, 37.5% were Black participants, 45.4% were women, and mean age was 73.2 (SD, 9.5) years. The unadjusted hazard ratio for CVD events comparing Black to White participants was 1.42 (95% CI, 1.17-1.71). Adjusting for sociodemographic characteristics did not attenuate the association (1.41 95% CI, 1.14-1.73), but further adjusting for pre-MI health status (1.25 95% CI, 1.00-1.56) and characteristics of the MI (1.01 95% CI, 0.80-1.27) resulted in substantial attenuation. Similar patterns were observed for the other outcomes, although the number of strokes was small. CONCLUSIONS: Black individuals had a higher risk of CVD events and mortality after MI than White individuals. The disparities were explained by health status before MI and characteristics of the MI. These findings suggest that both primordial prevention of risk factors and improved acute treatment strategies are needed to reduce disparities in post-MI outcomes.
Blackston et al. (Tue,) conducted a cohort in Incident myocardial infarction (n=1,122). Black adults vs. White adults was evaluated on CVD events (MI, stroke, HF hospitalization, or death from CVD) (HR 1.42, 95% CI 1.17-1.71). Black adults had a higher unadjusted risk of post-MI CVD events than White adults (HR 1.42; 95% CI 1.17-1.71), which was attenuated after adjusting for pre-MI health and MI characteristics (HR 1.01).