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罗姆族和非罗姆族患者冠状动脉造影术后七年死亡率

Seven years' mortality in Roma and non-Roma patients after coronary angiography.

作者信息

Sudzinova Adriana, Nagyova Iveta, Rosenberger Jaroslav, Studencan Martin, Vargova Helena, Middel Berrie, van Dijk Jitse P, Reijneveld Sijmen A

机构信息

1 East Slovakian Institute for Cardiac and Vascular Diseases, Cardiology Clinic, Kosice, Slovak Republic 2 Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovak Republic

2 Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovak Republic 3 Institute of Public Health, Department of Social Medicine, Medical Faculty, Safarik University, Kosice, Slovak Republic.

出版信息

Eur J Public Health. 2015 Oct;25(5):765-9. doi: 10.1093/eurpub/ckv057. Epub 2015 Mar 30.

Abstract

BACKGROUND

Ethnicity is associated with differences in clinical course and outcomes of cardiac disease, often in association with a poorer socioeconomic position. The aim of this study was to compare the mortality after coronary angiography (CAG) of Roma and non-Roma patients matched for education and adjusted for gender and age.

METHODS

In total, 816 patients were included in the study (167 Roma and 649 non-Roma). Data on socio-demographic background, disease history, use of drugs, coronary findings and type of treatment were obtained from medical records. Mortality was assessed up to seven years after CAG. Kaplan-Meier curves of mortality were plotted, and differences between the Roma and non-Roma patients were assessed using log-rank tests, matched for education and adjusted for gender and age.

RESULTS

Mortality after CAG was significantly higher among Roma than non-Roma (log-rank test χ(2) = 7.59, P < 0.01) and remained so after matching for education and adjustment for gender, age, history of previous myocardial infarction and abnormal CAG (hazard ratio: 2.07, 95% confidence interval: 1.13-3.82).

CONCLUSION

Mortality after CAG is higher among Roma, and this is not due to differences in age, gender or education. These results warrant further reconsideration of the management of Roma cardiac patients.

摘要

背景

种族与心脏病临床病程及预后差异相关,且常与较差的社会经济地位有关。本研究旨在比较经教育程度匹配、并根据性别和年龄进行调整后的罗姆族和非罗姆族患者冠状动脉造影(CAG)后的死亡率。

方法

本研究共纳入816例患者(167例罗姆族和649例非罗姆族)。从医疗记录中获取社会人口学背景、疾病史、药物使用、冠状动脉检查结果及治疗类型等数据。对CAG后长达七年的死亡率进行评估。绘制死亡率的Kaplan-Meier曲线,并使用对数秩检验评估罗姆族和非罗姆族患者之间的差异,按教育程度匹配,并根据性别、年龄、既往心肌梗死病史和CAG异常进行调整。

结果

CAG后的死亡率在罗姆族中显著高于非罗姆族(对数秩检验χ(2)=7.59,P<0.01),在按教育程度匹配并根据性别、年龄、既往心肌梗死病史和CAG异常进行调整后仍然如此(风险比:2.07,95%置信区间:1.13-3.82)。

结论

CAG后的死亡率在罗姆族中较高,且这并非由于年龄、性别或教育程度的差异。这些结果值得对罗姆族心脏病患者的管理进行进一步重新考量。

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