种族与主要心脏不良事件(MACE)的关联:社区(ARIC)队列中的动脉粥样硬化风险。

IF 1.6 Q4 GERIATRICS & GERONTOLOGY Journal of Aging Research Pub Date : 2020-03-21 eCollection Date: 2020-01-01 DOI:10.1155/2020/7417242
Ericha G Franey, Donna Kritz-Silverstein, Erin L Richard, John E Alcaraz, Caroline M Nievergelt, Richard A Shaffer, Vibha Bhatnagar
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引用次数: 7

摘要

背景和目的:评估自我报告的种族与主要心脏不良事件(MACE)的关系,以及对氧磷酶基因(PON1、PON2和PON3)单核苷酸多态性(SNPs)对这种关系的修饰。方法:这项纵向研究包括12,770名来自社区动脉粥样硬化风险(ARIC)队列的黑人或白人参与者,他们完成了基线访问(1987-1989),并进行了PON基因分型。在基线时获得人口统计、行为和健康信息。MACE定义为到2004年首次发生心肌梗死、中风或冠心病相关死亡。在调整年龄、性别、其他人口统计学和心血管危险因素(如糖尿病和高血压)后,使用Cox比例风险回归来评估种族与MACE之间的关系。我们还评估了PON snp与MACE之间关系的改变。结果:黑人占ARIC队列的24.6%;总体而言,14.0%的参与者发展为MACE。与白人相比,在调整了年龄、性别、体重指数、吸烟和饮酒、教育和婚姻状况以及阿司匹林的使用后,黑人发生MACE的风险是白人的1.24倍(OR = 1.24,95%CI = 1.10,1.39)。在进一步调整高胆固醇、糖尿病和高血压后,这种关联变得不显著。经多重比较Bonferroni校正后,评价的snp均未达到显著性水平(p < 0.001)。结论:在调整高胆固醇、糖尿病和高血压因素后,未发现种族与MACE之间的关联,提示合并症是MACE的主要决定因素;以生活方式和健康管理为重点的医疗干预可以改善MACE的发展。需要进一步的研究来证实这一观察结果。
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Association of Race and Major Adverse Cardiac Events (MACE): The Atherosclerosis Risk in Communities (ARIC) Cohort.

Background and aims: To evaluate the association of self-reported race with major adverse cardiac events (MACE) and modification of this association by paraoxonase gene (PON1, PON2, and PON3) single nucleotide polymorphisms (SNPs).

Methods: Included in this longitudinal study were 12,770 black or white participants from the Atherosclerosis Risk in Communities (ARIC) cohort who completed a baseline visit (1987-1989) with PON genotyping. Demographic, behavioral, and health information was obtained at baseline. MACE was defined as first occurrence of myocardial infarction, stroke, or CHD-related death through 2004. Cox proportional hazards regression was used to evaluate the association between race and MACE after adjustment for age, gender, and other demographic and cardiovascular risk factors such as diabetes and hypertension. Modification of the association between PON SNPs and MACE was also assessed.

Results: Blacks comprised 24.6% of the ARIC cohort; overall, 14.0% of participants developed MACE. Compared with whites, blacks had 1.24 times greater hazard of MACE (OR = 1.24,95%CI = 1.10,1.39) than whites after adjusting for age, gender, BMI, cigarette and alcohol use, educational and marital status, and aspirin use. This association became nonsignificant after further adjustment for high cholesterol, diabetes, and hypertension. None of the evaluated SNPs met the significance level (p < 0.001) after Bonferroni correction for multiple comparisons.

Conclusions: No association between race and MACE was identified after adjusting for high cholesterol, diabetes, and hypertension, suggesting that comorbidities are major determinants of MACE; medical intervention with focus on lifestyle and health management could ameliorate the development of MACE. Further studies are needed to confirm this observation.

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来源期刊
Journal of Aging Research
Journal of Aging Research Medicine-Geriatrics and Gerontology
CiteScore
5.40
自引率
0.00%
发文量
11
审稿时长
30 weeks
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