Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
Heart Institute, Holon Medical Center, Tel Aviv Jaffa District, Clalit Health Fund, Israel.
Cardiovasc Revasc Med. 2020 Nov;21(11):1431-1435. doi: 10.1016/j.carrev.2020.04.023. Epub 2020 Apr 23.
Life expectancy has increased in Israel during recent decades. However, compared to the majority, mostly Jewish population, life expectancy remains low among Israeli Arabs minority, and cardiovascular diseases are the leading cause of death. We compared baseline characteristics and outcomes between Israeli Arab and non-Arab patients hospitalized with acute coronary syndrome (ACS).
A national survey accessed data of 7055 patients (1251, 18% Arabs) hospitalized with ACS. Compared to non-Arab, Arab patients were younger at ACS presentation (59 ± 11 vs. 65 ± 12 years, p < 0.01), more likely male (81% vs. 77%, p = 0.01), and with higher prevalence of diabetes mellitus (47% vs. 34%, p < 0.01) and smoking history (57% vs. 34%, p < 0.001). Among patients with ST-elevation myocardial infarction (STEMI) ACS, the mean time from first medical contact to the hospital was similar for Arab and non-Arab patients (133 and 137 min, respectively). After adjustment for age, gender, time from first medical contact to hospital arrival, diabetes, hypertension and renal failure, 1-year survival was lower among Arab patients (93.4% vs. 95.1%, p = 0.027), and 5-year survival was not statistically different (84.0% vs. 86.8%, p = 0.059). The survival differences were mostly derived from reduced survival at 1 and 5 years of STEMI Arab patients.
Israeli Arabs present with ACS at a younger age than non-Arabs and have higher prevalence of smoking and diabetes at presentation. Adjusted 1-year survival was lower among Arab patients. Access to medical care and in-hospital practices during ACS were similar for Arabs and non-Arabs. The findings highlight the impact of risk factors on the early presentation of ACS and the need for a robust risk reduction program for Israeli Arabs.
在过去几十年中，以色列的预期寿命有所增加。然而，与大多数主要是犹太人的人口相比，以色列阿拉伯少数民族的预期寿命仍然较低，心血管疾病是导致死亡的主要原因。我们比较了因急性冠状动脉综合征（ACS）住院的以色列阿拉伯人和非阿拉伯患者的基线特征和结局。
一项全国性调查获取了 7055 名 ACS 住院患者（1251 名，18%为阿拉伯人）的数据。与非阿拉伯人相比，阿拉伯人 ACS 发病时更年轻（59±11 岁 vs. 65±12 岁，p<0.01），男性比例更高（81% vs. 77%，p=0.01），糖尿病（47% vs. 34%，p<0.01）和吸烟史（57% vs. 34%，p<0.001）的患病率更高。在 ST 段抬高型心肌梗死（STEMI）ACS 患者中，阿拉伯和非阿拉伯患者从首次医疗接触到入院的平均时间相似（分别为 133 和 137 分钟）。在调整年龄、性别、从首次医疗接触到入院的时间、糖尿病、高血压和肾衰竭后，阿拉伯患者的 1 年生存率较低（93.4% vs. 95.1%，p=0.027），5 年生存率无统计学差异（84.0% vs. 86.8%，p=0.059）。生存差异主要来自 STEMI 阿拉伯患者 1 年和 5 年生存率的降低。
与非阿拉伯人相比，以色列阿拉伯人因 ACS 就诊时更年轻，且发病时吸烟和糖尿病的患病率更高。调整后的阿拉伯患者 1 年生存率较低。阿拉伯人和非阿拉伯人在 ACS 期间接受医疗服务和住院治疗的方式相似。这些发现突出了危险因素对 ACS 早期发病的影响，以及为以色列阿拉伯人制定强有力的风险降低计划的必要性。
