Department of Internal Medicine, New York Medical College/Landmark Medical Center, Woonsocket, RI 02895, USA.
Department of Medicine, Smt. NHL Municipal Medical College, Ahmedabad 380006, Gujarat, India.
Medicina (Kaunas). 2024 May 11;60(5):800. doi: 10.3390/medicina60050800.
: Non-Hodgkin lymphoma (NHL) has the sixth-highest malignancy-related mortality in the United States (US). However, inequalities exist in access to advanced care in specific patient populations. We aim to study the racial disparities in major adverse cardiovascular and cerebrovascular events (MACCEs) in NHL patients. : Using ICD-10 codes, patients with NHL were identified from the US National Inpatient Sample 2016-2019 database. Baseline characteristics, comorbidities, and MACCE outcomes were studied, and results were stratified based on the patient's race. : Of the 777,740 patients with a diagnosis of NHL, 74.22% (577,215) were White, 9.15% (71,180) were Black, 9.39% (73,000) were Hispanic, 3.33% (25,935) were Asian/Pacific Islander, 0.36% (2855) were Native American, and 3.54% (27,555) belonged to other races. When compared to White patients, all-cause mortality (ACM) was significantly higher in Black patients (aOR 1.27, 95% CI 1.17-1.38, < 0.001) and in Asian/Pacific Islander patients (aOR 1.27, 95% CI 1.12-1.45, < 0.001). Sudden cardiac death was found to have a higher aOR in all racial sub-groups as compared to White patients; however, it was statistically significant in Black patients only (aOR 1.81, 95% CI 1.52-2.16, < 0.001). Atrial fibrillation (AF) risk was significantly lower in patients who were Black, Hispanic, and of other races compared to White patients. Acute myocardial infarction (AMI) was noted to have a statistically significantly lower aOR in Black patients (0.70, 95% CI 0.60-0.81, < 0.001), Hispanic patients (0.69, 95% CI 0.59-0.80, < 0.001), and patients of other races (0.57, 95% CI 0.43-0.75, < 0.001) as compared to White patients. : Racial disparities are found in MACCEs among NHL patients, which is likely multifactorial, highlighting the need for healthcare strategies stratified by race to mitigate the increased risk of MACCEs. Further research involving possible epigenomic influences and social determinants of health contributing to poorer outcomes in Black and Asian/Pacific Islander patients with NHL is imperative.
非霍奇金淋巴瘤(NHL)是美国恶性肿瘤相关死亡率第六高的疾病。然而,在某些特定患者群体中,获得先进治疗的机会存在不平等现象。我们旨在研究 NHL 患者主要不良心血管和脑血管事件(MACCE)中的种族差异。
使用 ICD-10 代码,从 2016-2019 年美国国家住院患者样本数据库中确定 NHL 患者。研究了基线特征、合并症和 MACCE 结果,并根据患者的种族对结果进行分层。
在诊断为 NHL 的 777740 名患者中,74.22%(577215 名)为白人,9.15%(71180 名)为黑人,9.39%(73000 名)为西班牙裔,3.33%(25935 名)为亚裔/太平洋岛民,0.36%(2855 名)为美洲原住民,3.54%(27555 名)属于其他种族。与白人患者相比,黑人患者(OR1.27,95%CI1.17-1.38,<0.001)和亚裔/太平洋岛民患者(OR1.27,95%CI1.12-1.45,<0.001)的全因死亡率(ACM)明显更高。与白人患者相比,所有种族亚组的心脏性猝死的 OR 均较高;然而,只有黑人患者的差异具有统计学意义(OR1.81,95%CI1.52-2.16,<0.001)。与白人患者相比,黑人、西班牙裔和其他种族患者的心房颤动(AF)风险明显较低。与白人患者相比,急性心肌梗死(AMI)的 OR 黑人患者(0.70,95%CI0.60-0.81,<0.001)、西班牙裔患者(0.69,95%CI0.59-0.80,<0.001)和其他种族患者(0.57,95%CI0.43-0.75,<0.001)明显较低。
NHL 患者的 MACCE 中存在种族差异,这可能是多因素的,突出表明需要制定按种族分层的医疗保健策略,以降低 MACCE 的风险。进一步研究可能涉及影响 NHL 黑人和亚裔/太平洋岛民患者预后的表观基因组学影响和健康的社会决定因素至关重要。