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Subclinical myocardial injury and cardiovascular mortality: Racial differences in prevalence and risk (from the third National Health and Nutrition Examination survey). Ann Noninvasive Electrocardiol 2021 Jul;26(4):e12827

Date

03/07/2021

Pubmed ID

33675082

Pubmed Central ID

PMC8293602

DOI

10.1111/anec.12827

Scopus ID

2-s2.0-85102054773 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

BACKGROUND: Subclinical myocardial injury (SCMI) determined from the Electrocardiographic Cardiac Infarction/Injury Score (CIIS) is associated with increased risk of cardiovascular disease and mortality. We hypothesized that SCMI prevalence and association with mortality would differ by race, categorized as non-Hispanic White (White), non-Hispanic Black (Black), and Mexican American.

METHODS: Our analysis included 5,852 participants (age 58.5 ± 13.2 years; 54% women, 52% Whites, 23% Blacks, and 25% Mexican American participants) from the National Health and Nutrition Examination Survey (NHANES III, 1988-94) who were free of cardiovascular disease at the time of enrollment. SCMI was defined as the presence of CIIS ≥ 10 score points on the 12-lead ECG. Prevalence of SCMI and its association with cardiovascular mortality were examined in each race/ethnic group in models adjusted for sociodemographics and common cardiovascular risk factors.

RESULTS: SCMI prevalence was 23.4% in Whites, 21.8% in Blacks, and 18.0% in Mexican Americans. Compared to Whites, Blacks were as likely to have SCMI (odds ratio [OR] 0.95, 95% confidence interval [CI] 0.80-1.13), while Mexican Americans were less likely (OR 0.74, 95% CI 0.62-0.88). SCMI was not associated with increased risk of cardiovascular mortality in either Whites (hazard ratio [HR] 1.18, 95% CI 0.95-1.48) or Blacks (HR 1.19, 95% CI 0.79-1.80). In contrast, SCMI in Mexican Americans was associated with increased risk of cardiovascular mortality (HR 1.74, 95% CI 1.13-2.67, p < .05).

CONCLUSION: Mexican Americans had a lower prevalence of SCMI, but increased risk of cardiovascular mortality. Screening for SCMI may identify individuals at increased risk and improve targeted prevention efforts.

Author List

Broughton ST, Ahmad M, Soliman EZ, Magnani JW

Author

Muhammad Imtiaz Ahmad MBBS Assistant Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Infarction
Nutrition Surveys
Prevalence
Risk Factors
United States