July 1, 2011Circulation Cardiovascular Quality and Outcomes119 citationsOpen Access
Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (TRIUMPH)
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Key Result
The TRIUMPH prospective registry enrolled 4,340 patients with acute myocardial infarction across 24 US centers to investigate factors mediating racial disparities in mortality and health status.
Key Points
- The study aims to explore how racial disparities impact health status and outcomes in patients with myocardial infarction.
- Prospective screening of 31,567 patients with myocardial infarction across 24 US centers.
- Collection of detailed clinical, genetic, and metabolic data from 4,340 enrolled patients.
- Follow-up interviews conducted at 1, 6, and 12 months to assess patients' postdischarge health status.
- Detailed data collection will enable examination of the role of genetic, metabolic, and socioeconomic factors in post-MI outcomes.
- Vital status verified for 99% of patients at 12 months, indicating strong follow-up.
- Loss to follow-up rates at 1, 6, and 12 months were 23%, 27%, and 24%, respectively.
Study Design
Type
Observational (n=4,340)
Multicenter
Yes
Structured PICO
Do racial differences in socioeconomic, clinical, genetic, metabolic, biomarker, or treatment characteristics mediate observed disparities in outcomes after myocardial infarction?
P
Population
4,340 patients with eligible myocardial infarction enrolled from 24 US centers
O
Outcome
Racial differences in mortality and health status (symptoms, function, and quality of life) after MI
The TRIUMPH registry provides a comprehensive dataset to investigate the complex genetic, clinical, and environmental factors mediating racial disparities in post-myocardial infarction outcomes.
Limitations
- High loss to follow-up rates at 1, 6, and 12 months (23%, 27%, and 24%, respectively)
- High loss to follow-up for interviews at 1, 6, and 12 months (23%, 27%, and 24% respectively)
Abstract
BACKGROUND: Black patients with myocardial infarction (MI) have worse outcomes than white patients, including higher mortality rates, more angina, and worse quality of life. The Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (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 April 11, 2005, and December 31, 2008, 31 567 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' postdischarge 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%, respectively, 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' sociodemographic, 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.
Cite This Study
Arnold et al. (2011) conducted an observational in Acute Myocardial Infarction (n=4,340). The TRIUMPH prospective registry enrolled 4,340 patients with acute myocardial infarction across 24 US centers to investigate factors mediating racial disparities in mortality and health status.