Differences in incident and recurrent myocardial infarction among White and Black individuals aged 35 to 84: Findings from the ARIC Community Surveillance Study

• Type of Material: Article
• Authors: Duygu Islek, Emory University; Alvaro Alonso, Emory University; Wayne Rosamond, University of North Carolina at Chapel Hill; Anna Kucharska-Newton, University of North Carolina at Chapel Hill; Yejin Mok, Johns Hopkins University; Kunihiro Matsushita, Johns Hopkins University; Silvia Koton, Johns Hopkins University; Michael Joseph Blaha, Johns Hopkins University; Mohammed K Ali, Emory University; Amita Manatunga, Emory University; Viola Vaccarino, Emory University
• Language: English
• Date: 2022-06-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 Published by Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1016/j.ahj.2022.05.020
• Title of Journal or Parent Work: American Heart Journal
• Volume: 253
• Start Page: 67
• End Page: 75
• Keywords: Recurrent myocardial infarction; community surveillance; risk, myocardial infarction outcomes; racial differences; racial disparities
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health

Abstract

Background: No previous study has examined racial differences in recurrent acute myocardial infarction (AMI) in a community population. We aimed to examine racial differences in recurrent AMI risk, along with first AMI risk in a community population. Methods: The community surveillance of the Atherosclerosis Risk in Communities Study (2005–2014) included 470000 people 35–84 years old in 4 U.S. communities. Hospitalizations for recurrent and first AMI were identified from ICD-9-CM discharge codes. Poisson regression models were used to compare recurrent and first AMI risk ratios between Black and White residents. Results: Recurrent and first AMI risk per 1000 persons were 8.8 (95% CI, 8.3–9.2) and 20.7 (95 % CI, 20.0–21.4) in Black men, 6.8 (95% CI, 6.5–7.0) and 14.1 (95 % CI, 13.8–14.5) in White men, 5.3 (95% CI, 5.0–5.7) and 16.2 (95 % CI, 15.6–16.8) in Black women, and 3.1 (95% CI, 3.0–3.3) and 8.8 (95 % CI, 8.6–9.0) in White women, respectively. The age-adjusted risk ratios (RR) of recurrent AMI were higher in Black men vs. White men (RR, 1.58 95 % CI, 1.30–1.92) and Black women vs. White women (RR, 2.09 95 % CI, 1.64–2.66). The corresponding RRs were slightly lower for first AMI: Black men vs. White men, RR, 1.49 (95 % CI, 1.30–1.71) and Black women vs. White women, RR, 1.65 (95 % CI, 1.42–1.92) Conclusions: Large disparities exist by race for recurrent AMI risk in the community. The magnitude of disparities is stronger for recurrent events than for first events, and particularly among women.