Durrani Asad F, Soma Siva, Althouse Andrew D, Leef George, Qin Dingxin, Saba Samir
Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Department of Medicine, Stanford University, Palo Alto, CA, USA.
J Immigr Minor Health. 2018 Feb;20(1):14-19. doi: 10.1007/s10903-016-0545-5.
Racial disparities between African American (AA) and White patients have been documented in cardiovascular disease. We investigated whether these disparities exist in patients undergoing rhythm control for atrial fibrillation (AF). 5873 AF patients (241 AA) were followed to the endpoint of death, stroke, or AF recurrence. Invasive procedures for AF rhythm control were examined in both racial groups. Over a mean follow-up time of 40 months, AA patients had a higher adjusted risk of death [HR 1.39, 95% CI 1.00-1.92, p = 0.043] and stroke [HR 1.90, 95% CI 1.13-3.15, p = 0.013] but a lower risk of AF recurrence [HR 0.79, 95% CI 0.63-0.97, p = 0.026]. In addition, AA patients were less likely to undergo AF ablation (p = 0.006) or surgical maze (p = 0.032) procedures compared to White patients, possibly due to the lower rates of AF recurrence. Significant racial disparities exist in the management and outcomes of AA and White patients undergoing rhythm control management for AF.
非裔美国人（AA）与白人患者在心血管疾病方面的种族差异已有记录。我们调查了在接受心房颤动（AF）节律控制的患者中是否存在这些差异。对5873例AF患者（241例AA患者）进行随访，直至出现死亡、中风或AF复发的终点事件。对两个种族群体中用于AF节律控制的侵入性手术进行了检查。在平均40个月的随访期内，AA患者死亡[风险比（HR）1.39，95%置信区间（CI）1.00 - 1.92，p = 0.043]和中风[HR 1.90，95% CI 1.13 - 3.15，p = 0.013]的调整后风险较高，但AF复发风险较低[HR 0.79，95% CI 0.63 - 0.97，p = 0.026]。此外，与白人患者相比，AA患者接受AF消融术（p = 0.006）或外科迷宫手术（p = 0.032）的可能性较小，这可能是由于AF复发率较低。在接受AF节律控制管理的AA患者和白人患者的治疗及预后方面存在显著的种族差异。
