Maynard C, Beshansky J R, Griffith J L, Selker H P
Department of Medicine, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
J Natl Med Assoc. 1997 Oct;89(10):665-71.
This study examines whether race is a significant determinant of the diagnoses of acute myocardial infarction or angina pectoris in patients with symptoms suggestive of acute cardiac ischemia. The study population was comprised of 3401 (34%) African-American and 6600 (66%) white patients who presented to emergency departments with symptoms suggestive of acute cardiac ischemia. The main outcome measure was a diagnosis of acute myocardial infarction or angina pectoris. African Americans were younger, predominantly female, and more often had hypertension, diabetes mellitus, or smoked. The diagnosis of acute myocardial infarction was confirmed in 6% of African-American and 12% of white men, and in 4% of African-American and 8% of white women. After adjusting for age, gender, medical history, signs and symptoms, and hospital, African Americans were half as likely to develop acute myocardial infarction and were 60% as likely to have acute cardiac ischemia. Despite having less acute cardiac ischemia, African Americans in this study had high risk levels for coronary artery disease.
本研究探讨种族是否为有急性心脏缺血症状患者急性心肌梗死或心绞痛诊断的重要决定因素。研究人群包括3401名（34%）非裔美国人和6600名（66%）白人患者，他们因有急性心脏缺血症状而前往急诊科就诊。主要结局指标为急性心肌梗死或心绞痛的诊断。非裔美国人年龄更小，女性居多，且更常患有高血压、糖尿病或吸烟。在非裔美国男性中，6%被确诊为急性心肌梗死，白人男性中这一比例为12%；在非裔美国女性中，4%被确诊为急性心肌梗死，白人女性中这一比例为8%。在对年龄、性别、病史、体征和症状以及医院进行校正后，非裔美国人发生急性心肌梗死的可能性为白人的一半，发生急性心脏缺血的可能性为白人的60%。尽管本研究中的非裔美国人急性心脏缺血情况较少，但他们患冠状动脉疾病的风险水平较高。
