Ethnicity-Related Clinical Disparities among Coronary Artery Disease Patients, a-20 Years Outcome Study

Arsalan Abu Much The Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel Nir Shlomo The Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel Ilan Goldenberg The Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel Heart Research Follow-up Program, University of Rochester, Rochester, NY, USA Robert Klempfner The Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel Arwa Younis The Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel

Background Data regarding the long-term association of ethnic differences with adverse outcomes are conflicting. We aim to determine the independent association of these differences with 20-year all-cause mortality among patients with stable coronary artery disease (CAD).

Methods our study comprised 15,524 patients who were enrolled in the Bezafibrate Infarction PreventionregistrybetweenFebruary 1, 1990, and October 31, 1992, and subsequently followed-up for the long-term mortality through December 31, 2014.We compared clinical characteristics and outcomes between Israeli Arabs and Jews. Propensity score matching (PSM) (1:2 ratios) was further used.

Results 958 (6%) patients were Arabs.They were significantly younger (56±7 y vs 60±7 y; p<0.001; respectively. Before PSM, Kaplan-Meier survival analysis showed that all-cause mortality was significantly higher among Arab patients with (67% vs. 61%; log rank-p<0.001)(Left figure). Multivariate-adjusted mortality risk was 65% greater ( HR 1.65; 95% CI 1.52-1.79) among Arab patients compared with Jews. Similar results were obtained after PSM model was performed (Right figure).

Conclusions Arab Ethnicity is independently associated with an increased20-year all-cause mortality risk among patients with stable CAD. This association was consistent even after performing a propensity score matching.

kaplan-meier graph for twenty year survival

Arsalan Abu Much

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