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. 2021 Jun 30:8:661390.
doi: 10.3389/fcvm.2021.661390. eCollection 2021.

Ethnic Disparity in Mortality Among Ischemic Heart Disease Patients. A-20 Years Outcome Study From Israel

Arsalan Abu-Much  1 , Eyal Nof  1 , Nicola Luigi Bragazzi  2 , Anan Younis  1 , David Hochstein  3 , Arwa Younis  1 , Nir Shlomo  1 , Alexander Fardman  1 , Ilan Goldenberg  4 , Robert Klempfner  1 , Roy Beinart  1   5
Affiliations

Ethnic Disparity in Mortality Among Ischemic Heart Disease Patients. A-20 Years Outcome Study From Israel

Arsalan Abu-Much et al. Front Cardiovasc Med. .

Abstract

Background: Long-term morbidity and mortality data among ischemic heart disease (IHD) patients of different ethnicities are conflicting. We sought to determine the independent association of ethnicity and all-cause mortality over two decades of follow-up of Israeli patients. Methods: Our study comprised 15,524 patients including 958 (6%) Arab patients who had been previously enrolled in the Bezafibrate Infarction Prevention (BIP) registry between February 1, 1990, and October 31, 1992, and subsequently followed-up for long-term mortality. We compared clinical characteristics and outcomes of Israeli Arabs and Jews. Propensity score matching (PSM) (1:2 ratios) was used for validation. Results: Arab patients were significantly younger (56 ± 7 years vs. 60 ± 7 years; p < 0.001; respectively), and had more cardiovascular disease (CVD) risk factors. Kaplan-Meier survival analysis showed that all-cause mortality was significantly higher among Arab patients (67 vs. 61%; log-rank p < 0.001). Multivariate adjusted analysis showed that mortality risk was 49% greater (HR 1.49; 95% CI: 1.37-1.62; p < 0.001) among Arabs. Conclusions: Arab ethnicity is independently associated with an increased 20-year all-cause mortality among patients with established IHD.

Keywords: all-cause mortality; disparity; ethnicity; heart disease; ischemic heart disease.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flow chart. BIP, Bezafibrate Infarction Prevention; IHD, ischemic heart disease.
Figure 2
Figure 2
(A) Kaplan-Meier of 20-year survival estimates for the entire cohort according to ethnicity. (B) Kaplan-Meier of 20-year survival estimates for the propensity score matched cohort according to ethnicity.
Figure 3
Figure 3
Subgroup analysis predicting the association between 20-year all-cause mortality and Arab ethnicity. HR, Hazard Ratio; CI, Confidence Interval; BMI, Body Mass Index; DM, Diabetes Mellitus; MI, Myocardial Infarction.
See this image and copyright information in PMC

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