东欧少数民族缺血性心脏病的长期死亡率较高：罗马尼亚一项针对所有前来接受经皮冠状动脉介入治疗患者的前瞻性登记研究结果

High long-term mortality in ischaemic heart disease accentuated among ethnic minorities in Eastern Europe: findings from a prospective all-comers percutaneous coronary intervention registry in Romania.

作者信息

Călburean Paul-Adrian, Grebenișan Paul, Nistor Ioana-Andreea, Șulea Ioana Paula, Scurtu Anda-Cristina, Brinzaniuc Klara, Suciu Horatiu, Harpa Marius, Dobreanu Dan, Hadadi Laszlo

机构信息

George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania

Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures, Romania.

出版信息

J Epidemiol Community Health. 2025 Mar 10;79(4):272-279. doi: 10.1136/jech-2024-222845.

DOI:10.1136/jech-2024-222845

PMID:39532395

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12015071/

Abstract

BACKGROUND

Long-term outcomes in cardiovascular diseases are historically under-reported in Eastern Europe. Our aim was to report long-term survival and to identify survival predictors in a prospective Romanian percutaneous coronary intervention (PCI) registry, with an emphasis on important under-resourced minorities, such as Hungarian and Roma ethnicities.

METHODS

An all-comers patient population treated by PCI in a tertiary cardiovascular centre that has been included prospectively in the local registry since January 2016 was analysed. Cardiovascular cause and all-cause mortality data were available as of December 2023.

RESULTS

A total of 6867 patients with 8442 PCI procedures were included. Romanian group consisted of 5095 (74.2%) patients, the Hungarian group consisted of 1417 (20.6%) patients and the Roma group consisted of 355 (5.1%) patients. During a median follow-up of 3.60 (1.35-5.75) years, a total of 1064 cardiovascular-cause and 1374 all-cause events occurred. Romanian, Hungarian and Roma patients suffered 5.12, 5.89 and 7.71 all-cause deaths per 100 patient-years, respectively. Romanian, Hungarian and Roma patients suffered 3.94, 4.63 and 6.22 cardiovascular-cause deaths per 100 patient-years, respectively. Both Hungarian and Roma patients presented significantly higher all-cause mortality than Romanian patients (adjusted HR (aHR)=1.20 (1.05-1.36), p=0.005 and aHR=1.51 (1.21-1.88), p=0.0001). Similarly, Hungarian and Roma patients presented significantly higher cardiovascular cause mortality than Romanian patients (aHR=1.22 (1.05-1.41), p=0.006 and aHR=1.51 (1.18-1.92), p=0.0008).

CONCLUSIONS

High long-term cardiovascular and all-cause mortality was observed for the entire included population. Long-term survival was significantly lower in ethnic minorities, such as the Hungarian and Roma minority than in the Romanian population.

摘要

背景

在东欧，心血管疾病的长期预后在历史上报道不足。我们的目的是报告罗马尼亚经皮冠状动脉介入治疗（PCI）前瞻性登记处的长期生存率，并确定生存预测因素，重点关注资源严重不足的少数群体，如匈牙利族和罗姆族。

方法

分析了自2016年1月起前瞻性纳入当地登记处的三级心血管中心所有接受PCI治疗的患者群体。截至2023年12月可获得心血管病因和全因死亡率数据。

结果

共纳入6867例患者，进行了8442例PCI手术。罗马尼亚组有5095例（74.2%）患者，匈牙利组有1417例（20.6%）患者，罗姆组有355例（5.1%）患者。在中位随访3.60（1.35 - 5.75）年期间，共发生1064例心血管病因事件和1374例全因事件。罗马尼亚、匈牙利和罗姆族患者每100患者年的全因死亡数分别为5.12、5.89和7.71例。罗马尼亚、匈牙利和罗姆族患者每100患者年的心血管病因死亡数分别为3.94、4.63和6.22例。匈牙利族和罗姆族患者的全因死亡率均显著高于罗马尼亚族患者（调整后风险比（aHR）=1.20（1.05 - 1.36），p = 0.005；aHR = 1.51（1.21 - 1.88），p = 0.0001）。同样，匈牙利族和罗姆族患者的心血管病因死亡率也显著高于罗马尼亚族患者（aHR = 1.22（1.05 - 1.41），p = 0.006；aHR = 1.51（1.18 - 1.92），p = 0.0008）。