Minority Health Archive

Race/ethnic disparities in risk factor control and survival in the bypass angioplasty revascularization investigation 2 diabetes (BARI 2D) trial.

Beohar, Nirat and Sansing, Veronica V. and Davis, Andrew M. and Srinivas, V. S. and Helmy, Tarek and Althouse, Andrew D. and Thomas, Stephen B. and Brooks, Maria Mori (2013) Race/ethnic disparities in risk factor control and survival in the bypass angioplasty revascularization investigation 2 diabetes (BARI 2D) trial. American Journal of Cardiology, 112 (9). pp. 1298-1305.

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Abstract

This study sought to evaluate the impact of race/ethnicity on cardiovascular risk factor control and on clinical outcomes in a setting of comparable access to medical care. The BARI 2D trial enrolled 1,750 participants from the United States and Canada that self-reported either White non-Hispanic (n [ 1,189), Black non-Hispanic (n =349), or Hispanic (n =212) race/ethnicity. Participants had type 2 diabetes and coronary artery disease and were randomized to cardiac and glycemic treatment strategies. All patients received intensive target-based medical treatment for cardiac risk factors. Average follow-up was 5.3 years. Kaplan-Meier survival curves and Cox proportional hazards regression models were constructed to assess potential differences in mortality and cardiovascular outcomes across racial/ethnic groups. Long-term risk of death and death/myocardial infarction/stroke did not vary significantly by race/ethnicity (5-year death: 11.0% Whites, 13.7% Blacks, 8.7% Hispanics, p =0.19; adjusted hazard ratio 1.18 Black versus White, 95% confidence interval 0.84 to 1.67, p = 0.33 and 0.82 Hispanic versus White, 95% confidence interval 0.51 to 1.34, p =0.43). Among the 1,168 patients with suboptimal risk factor control at baseline, the ability to attain better risk factor control during the trial was associated with higher 5-year survival (71%, 86% and 95% for patients with 0 or 1, 2, and 3 factors in control, respectively, p <0.001); this pattern was observed within each race/ethnic group. In conclusion, significant race/ethnic differences in cardiac risk profiles that persisted during follow-up did not translate into significant differences in 5-year death or death/MI/stroke.


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Item Type: Article
Subjects: Health > Disparities
Health > Public Health > Chronic Illness & Diseases
Related URLs:
    Depositing User: Ms Danielle Motley
    Date Deposited: 01 Mar 2015 11:52
    Last Modified: 01 Mar 2015 11:52
    Link to this item (URI): http://health-equity.lib.umd.edu/id/eprint/4219

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