Black-white differences in mortality in idiopathic dilated cardiomyopathy

the Washington, DC, dilated cardiomyopathy study.

Steven Scott Coughlin, J. S. Gottdiener, K. L. Baughman, A. Wasserman, E. S. Marx, M. C. Tefft, B. J. Gersh

Research output: Contribution to journalArticle

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Abstract

Racial, socioeconomic, and clinical factors were examined as predictors of survival in idiopathic dilated cardiomyopathy using cases from five Washington, DC-area hospitals. One hundred three (80.5%) of the patients were black and 25 (19.5%) were white. The black patients were less likely to have private health insurance, less educated on average, and more likely to have a household income of $15,000 or less (P < or = .05). No racial differences were found in cardiac medication usage, with the exception of beta blockers and antiarrhythmics. The cumulative survival among black patients at 12 and 24 months was 71.5% and 63.6%, respectively, as compared with 92.0% and 86.3% among whites. The 12-month survival of black patients with ventricular arrhythmias or an ejection fraction of less than 25% was particularly poor. Age, ventricular arrhythmias, ejection fraction, and cigarette usage were significant predictors of survival in univariate analysis using the proportional hazards model. The univariate association with black race was of borderline significance (P < or = .07). In multivariate analysis, age and race were statistically significant independent predictors of survival. A strong association with black race was observed with an estimated relative risk of mortality of 5.41 (P < or = .02) after adjustment for age, ejection fraction, ventricular arrhythmias, and educational attainment. Poorer survival among blacks may be caused by a greater severity of disease at the time of diagnosis or by racial differences in cardiac care, comorbid conditions, or biologic factors affecting survival.

Original languageEnglish (US)
Pages (from-to)583-591
Number of pages9
JournalJournal of the National Medical Association
Volume86
Issue number8
StatePublished - Jan 1 1994

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Dilated Cardiomyopathy
Survival
Mortality
Cardiac Arrhythmias
Stroke Volume
Biological Factors
Health Insurance
hydroquinone
Proportional Hazards Models
Tobacco Products
Multivariate Analysis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Coughlin, S. S., Gottdiener, J. S., Baughman, K. L., Wasserman, A., Marx, E. S., Tefft, M. C., & Gersh, B. J. (1994). Black-white differences in mortality in idiopathic dilated cardiomyopathy: the Washington, DC, dilated cardiomyopathy study. Journal of the National Medical Association, 86(8), 583-591.

Black-white differences in mortality in idiopathic dilated cardiomyopathy : the Washington, DC, dilated cardiomyopathy study. / Coughlin, Steven Scott; Gottdiener, J. S.; Baughman, K. L.; Wasserman, A.; Marx, E. S.; Tefft, M. C.; Gersh, B. J.

In: Journal of the National Medical Association, Vol. 86, No. 8, 01.01.1994, p. 583-591.

Research output: Contribution to journalArticle

Coughlin, Steven Scott ; Gottdiener, J. S. ; Baughman, K. L. ; Wasserman, A. ; Marx, E. S. ; Tefft, M. C. ; Gersh, B. J. / Black-white differences in mortality in idiopathic dilated cardiomyopathy : the Washington, DC, dilated cardiomyopathy study. In: Journal of the National Medical Association. 1994 ; Vol. 86, No. 8. pp. 583-591.
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abstract = "Racial, socioeconomic, and clinical factors were examined as predictors of survival in idiopathic dilated cardiomyopathy using cases from five Washington, DC-area hospitals. One hundred three (80.5{\%}) of the patients were black and 25 (19.5{\%}) were white. The black patients were less likely to have private health insurance, less educated on average, and more likely to have a household income of $15,000 or less (P < or = .05). No racial differences were found in cardiac medication usage, with the exception of beta blockers and antiarrhythmics. The cumulative survival among black patients at 12 and 24 months was 71.5{\%} and 63.6{\%}, respectively, as compared with 92.0{\%} and 86.3{\%} among whites. The 12-month survival of black patients with ventricular arrhythmias or an ejection fraction of less than 25{\%} was particularly poor. Age, ventricular arrhythmias, ejection fraction, and cigarette usage were significant predictors of survival in univariate analysis using the proportional hazards model. The univariate association with black race was of borderline significance (P < or = .07). In multivariate analysis, age and race were statistically significant independent predictors of survival. A strong association with black race was observed with an estimated relative risk of mortality of 5.41 (P < or = .02) after adjustment for age, ejection fraction, ventricular arrhythmias, and educational attainment. Poorer survival among blacks may be caused by a greater severity of disease at the time of diagnosis or by racial differences in cardiac care, comorbid conditions, or biologic factors affecting survival.",
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