EPIDEMIOLOGIC STUDY OF STROKE OUTCOME IN 3 ETHNIC GROUPS

3个民族脑卒中结果的流行病学研究

• 批准号: 3413814
• 负责人: Ralph L. Sacco
• 金额: $ 11.57万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-09-01 至 1994-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3413814
• 关键词: African American; Hispanic Americans; Native Americans; alcoholic beverage consumption; atherosclerosis; cardiovascular disorder epidemiology; case history; cerebrovascular occlusions; diabetic angiopathy; diabetic neuropathy; disease /disorder proneness /risk; embolism; heart disorder; human age group; human mortality; hypercholesterolemia; infarct; interview; lifestyle; myocardial infarction; questionnaires; racial /ethnic difference; relapse /recurrence; sign /symptom; stroke; tobacco abuse

Despite the reported decline in the incidence of stoke, there has not been a decline in stroke recurrence. Relatively little is known about whether ethnicity, independently or in conjunction with stroke risk factors, determines outcome after cerebral infarction. Most epidemiologic studies have been conducted predominately white populations. Less is known about black survivors of cerebral infarction, and few studies have been done in the growing Hispanic population. The study is designed to determine in whites, blacks and Hispanics the risk of stroke recurrence, myocardial infarction and death in 30 day survivors of cerebral infarction up to 10 years after an index event. Members of the cohort were admitted to the Neurological Institute of New York from 1983 to 1988. The majority are from Northern Manhattan, a community with many black and Hispanic residents. Columbia-Presbyterian Medical Center is the main provider of ambulatory and hospital care for this community. Risk factors for stroke, infarct subtype, adn findings on neurological examination and diagnostic studies, identified at the time of the initial cerebral infarction, have already been collected on the systematically evaluated cohort. Annual telephone follow-up of the patient or next of kin will be used to measure changes in risk factors and to identify those with stroke recurrence, symptomatic myocardial infarction or death. In-person follow-up interview and examination will be done on patients suspected of a subsequent event. Outcome after cerebral infarction will be analyzed by life table methods and Cox proportional hazards modelling. Stratification r the addition of other collected variables to the models are expected to show that the effect of ethnicity is not independent of other risk factors. Besides gaining new epidemiologic information on the risk and determinants of stoke recurrence, myocardial infarction and death after cerebral infarction in three ethnic groups, understanding the role of individual risk factors and their interactions with ethnicity will encourage more selective secondary prevention strategies.

尽管据报道中风的发病率有所下降，但并没有 中风复发率下降。人们对此知之甚少 无论种族，独立或与中风风险相关 因素，决定脑梗塞后的结局。 最多 流行病学研究主要是针对白人进行的 人口。 关于黑人脑损伤幸存者知之甚少 梗死，并且很少有研究针对日益增长的西班牙裔 人口。 该研究旨在确定白人、黑人和西班牙裔的 30天内中风复发、心肌梗死和死亡的风险 指标事件发生后 10 年内的脑梗塞幸存者。 该队列成员被新医学院神经病学研究所录取 1983 年至 1988 年期间居住在约克。大多数人来自曼哈顿北部， 有许多黑人和西班牙裔居民的社区。哥伦比亚长老会 医疗中心是门诊和住院护理的主要提供者 这个社区。 中风的危险因素、梗死亚型、及发现 神经学检查和诊断研究，在 初次脑梗塞的时间，已收集 系统评估的队列。 每年电话随访 患者或近亲将被用来测量危险因素的变化 并识别那些中风复发、有症状的心肌病患者 梗塞或死亡。 现场后续面试和考试将 对怀疑有后续事件的患者进行。 脑梗死后的转归将采用生命表法进行分析 和 Cox 比例风险建模。 分层与加法 模型中收集的其他变量预计会表明 种族的影响并不独立于其他危险因素。除了 获得有关风险和决定因素的新流行病学信息 脑卒中复发、心肌梗死和脑卒中死亡 三个种族群体的梗塞，了解个体的作用 风险因素及其与种族的相互作用将鼓励更多 选择性二级预防策略。