Diabetes Status and Racial Differences in Post Myocardial Infarction Mortality
Abstract Number: 1002-P
Authors: MASOOR KAMALESH, USHA SUBRAMANIAN, PANDURANG KULKARNI, ANAHITA ARIANA, STEPHEN SAWADA
Institutions: Indianapolis, IN
Results: Mortality from coronary disease (CAD) has been reported to be higher among blacks (B) than whites (W). Prevalence of diabetes (D) is higher in B. We hypothesized that D status could determine mortality difference between B and W and investigated this.
All veterans hospitalized for acute myocardial infarction (MI) at any veterans affairs medical center between 10/90 and 10/97 were identified. Demographic,clinical,follow up and mortality data were extracted and the impact of race on mortality was analyzed between subjects with and without D. Minimum follow up was 1 year and maximum followup was 8 years.
A total of 67,889 patients with MI were identified. Race status was known for 66,506 of whom 55,731 (84%)were W and 8437(13%) were B. At baseline W were older than B. Hypertension, D, and history of stroke were more common in B, while hyperlipidemia and history of (CAD) was more common in W. Of the 16,568(25%) subjects with D, 2480(15%) were B. At baseline, W with D were older, had more CAD and heart failure history. W has greater post MI coronary revascularization procedures. Mortality at 30 days and 1 year was higher for W(Adjusted HR 1.29, CI 1.03,1.63 and HR 1.22,CI 1.08,1.39). Among D, long term post-MI mortality was lower for B,(log rank p<0.001) while among nonD there was no difference between B and W.(Adjusted HR1.03, CI0.94,1.12)(figure)
D status determines racial difference in long term post MI mortality. Among subjects with D, B have lower long term mortality while there is no difference in long term post MI mortality among subjects without D.[figure1]