Young Women With Acute Myocardial Infarction

患有急性心肌梗塞的年轻女性

• 批准号: 7665331
• 负责人: Harlan Marc Krumholz
• 金额: $ 234.52万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7665331
• 关键词: Accounting; Acute myocardial infarction; Address; Age; Age-Years; American; American Heart Association; Biological; Biological Factors; Biological Markers; Biological Markers; Breast; Canada; Cardiac; Cardiology; Cardiovascular Diseases; Cardiovascular system; Caring; Cessation of life; Clinical; Clinical Investigator; Collaborations; Coronary heart disease; DNA; Data; Disease; Disease Outcome; Emergency Medicine; Enrollment; Ensure; Environment; Environmental Risk Factor; Epidemiology; Estrogens; Ethnic Origin; Excess Mortality; Female; Future; Genetic; Genetic Status; Genetic Variation; Gonadal Steroid Hormones; Guidelines; Health Status; Healthcare Systems; Heart Diseases; High Prevalence; Hospitalization; Hospitals; Inflammation; Inpatients; Intervention; Investigation; Knowledge; Letters; Measurement; Menstrual cycle; Metabolic; Metabolic syndrome; Minority; Modeling; Molecular Biology; Myocardial Infarction; Myocardial Ischemia; Observational Study; Outcome; Outcomes Research; Participant; Patients; Pattern; Phase; Phenotype; Physicians; Prevalence; Prevention; Prognostic Factor; Psychosocial Factor; Public Health; Publishing; Quality of Care; Quality of life; Race; Recommendation; Recording of previous events; Recovery; Reproductive History; Research; Research Personnel; Resources; Risk; Risk Factors; Serum; Sex Characteristics; Site; Specimen; Stratification; Symptoms; Time; United States; Update; Variant; Woman; Work; adverse outcome; age group; aged; cohort; college; comparison group; disorder risk; experience; functional status; genetic epidemiology; genetic resource; genetic variant; heart disease risk; high risk; improved; lipid metabolism; malignant breast neoplasm; men; mortality; neglect; non-genetic; novel; older women; outcome forecast; prognostic; programs; psychosocial; sex; social; statistics

DESCRIPTION (provided by applicant): Young women with an acute myocardial infarction (AMI) represent an extreme phenotype in ischemic heart disease risk and, at the same time, constitute a large understudied group with excess mortality risk compared with similarly aged men. This combination of adverse risk and inadequate investigation provides a critically important opportunity to address the care and outcomes of young women with AMI to uncover key biological and environmental determinants of their prognosis. Accordingly, we propose the first large, comprehensive, observational study of young women with AMI (YWAMI). YWAMI will include 2,000 women, 18-55 years of age, with AMI and a comparison cohort of 1,000 men enrolled over 3 years from 88 hospitals across the United States and in Canada. To accomplish these aims we have assembled a team of leading researchers in sex disparities in cardiovascular disease, outcomes research, epidemiology, statistics, genetics, biomarker research, health status measurement, psychosocial research, cardiology, and emergency medicine. Our Specific Aims are to: 1) characterize sex differences in outcomes following AMI (including mortality, hospitalization and health status); 2) determine sex differences in the prevalence of demographic, clinical, and psychosocial risk factors; 3) determine sex differences in quality of care; and 4) determine sex differences in the prevalence of selected biological factors (including sex hormones, biomarkers and genetic variations). We will characterize these differences in great detail and elucidate the biological and environmental factors that are responsible for disparities in outcomes. The analyses from all four aims will be used to develop clinically useful risk-stratification models for young AMI patients, explain sex differences in outcomes and identify targets for intervention. We will also bank serum and DMA from each subject, creating a resource for anticipated future studies of the molecular biology of AMI in young women and men. We will work with the American College of Cardiology, the American Heart Association and VHA, Inc. to disseminate findings from this study that can be used to improve the prevention, care, and outcomes for young women and men with AMI. Public Health Implications: Overall, although heart disease in young women accounts for as many deaths as breast cancer, few studies have addressed the biological, environmental and social factors that influence their outcome. Young women with heart attacks have a higher risk of dying than similarly aged men. We propose to conduct the largest, most comprehensive study of young women with heart attacks to identify the key determinants of their recovery and discover knowledge that will assist us in improving their care.

描述（由申请人提供）：患有急性心肌梗塞（AMI）的年轻女性代表缺血性心脏病风险中的极端表型，与此同时，与类似老年男性相比，构成了一个大量研究的人群，具有过高的死亡率。这种不利风险和不足调查的结合提供了一个至关重要的机会，可以解决AMI年轻女性的护理和结果，以发现其预后的关键生物学和环境决定因素。因此，我们提出了对AMI（YWAMI）年轻女性的第一项大型，全面的观察性研究。 Ywami将包括2,000名妇女，18-55岁，AMI和比较队列的1,000名男性在美国和加拿大的88家医院中招收了3年以上。为了实现这些目标，我们组建了一支领先的心血管疾病性别差异，结果研究，流行病学，统计学，遗传学，生物标志物研究，健康状况测量，心理社会研究，心脏病学和急诊医学的领先研究人员。我们的具体目的是：1）表征AMI后结果的性别差异（包括死亡率，住院和健康状况）； 2）确定人口，临床和社会心理风险因素的患病率的性别差异； 3）确定护理质量的性别差异； 4）确定选定生物学因素患病率的性别差异（包括性激素，生物标志物和遗传变异）。我们将详细地表征这些差异，并阐明导致结果差异的生物学和环境因素。所有四个目标的分析将用于为年轻AMI患者开发临床上有用的风险分层模型，解释结果的性别差异并确定干预目标。我们还将从每个主题中库存血清和DMA，为年轻男女的AMI分子生物学创造一种资源。我们将与美国心脏病学院，美国心脏协会和VHA，Inc。合作，从这项研究中传播发现，这些发现可用于改善AMI年轻男女的预防，护理和成果。公共卫生的影响：总的来说，尽管年轻女性的心脏病和乳腺癌的死亡人数众多，但很少有研究解决了影响其结果的生物学，环境和社会因素。患有心脏病发作的年轻女性比男性的死亡风险更高。我们建议对心脏病发作的年轻女性进行最大，最全面的研究，以确定其康复的关键决定因素，并发现知识，以帮助我们改善她们的护理。