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充血性心力衰竭预后及治疗效果的种族差异

Racial differences in outcome and treatment effect in congestive heart failure
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摘要 Background: In congestive heart failure(CHF), it is unknown whether race affects mortality and whether the effect of treatments differs by race. Methods: This study was a post hoc analysis of data from the DIG study that evaluated the effect of digoxin on morbidity and mortality in CHF. Results: Investigators followed 897 black and 6660 white participants for a mean of 37 months. Compared with whites, blacks were younger(60± 13 vs 65± 11 years). Total mortality was 34.2% in blacks and 33.6% in whites; hospitalization for worsening CHF occurred in 39% of blacks and 28% of whites. Cox regressions with race as the only covariate showed no effect of race on risk for death(relative risk=1.04, 95% CI 0.93- 1.18, P=.49)but an increase in CHF hospitalization in blacks(relative risk=1.52, 95% CI 1.35- 1.70, P=.0001). Multivariate Cox regression showed no difference by race in risk for death or death/hospitalization for CHF and no difference in the effect of digoxin on either end point. Conclusion: Race is not an independent predictor of mortality in CHF. The effect of digoxin on morbidity and mortality in CHF does not differ in blacks and whites. Background: In congestive heart failure(CHF), it is unknown whether race affects mortality and whether the effect of treatments differs by race. Methods: This study was a post hoc analysis of data from the DIG study that evaluated the effect of digoxin on morbidity and mortality in CHF. Results: Investigators followed 897 black and 6660 white participants for a mean of 37 months. Compared with whites, blacks were younger(60 ± 13 vs 65 ±11 years) . Total mortality was 34. 2% in blacks and 33.6% in whites; hospitalization for worsening CHF occurred in 39% of blacks and 28% of whites. Cox regressions with race as the only covariate showed no effect of race on risk for death (relative risk = 1.04, 95% CI 0. 93 - 1.18, P =. 49) but an increase in CHF hospitalization in blacks (relative risk = 1.52, 95% CI 1.35 - 1.70, P =. 0001) .
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