Impact of ethnic variation and residential segregation on long-term survival following myocardial perfusion SPECT

Azhar Supariwala, Seth Uretsky, Padmakshi Singh, Salim H. Memon, Supraja Yeturi, Surinder S. Khokhar, Gargi Thothakura, Alan Rozanski

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background. Ethnic characteristics of a neighborhood may impact upon all-cause mortality (ACM). It is not known whether this consideration remains a risk modifier among those being evaluated for CAD. Methods. 6,477 pts (60 ± 13 years, male 38%) residing in NYC with normal or abnormal stress SPECT studies were assessed for ACM during a mean follow-up of 9 ± 3.8 years. Baseline CAD risk factors and ethnic characteristics of patient neighborhoods were considered. Zip-codes with <70% of one ethnicity was considered to be predominant of that ethnicity. Results. There were 573 (20%) Hispanics (HS), 765 (27%) African-Americans (AA), and 250 (30%) Caucasians (CC) residing in areas <70% of their own ethnicity. Compared to CC, the risk for ACM was lower in HS (hazard ratio (HR) 0.68, 95% CI 0.57-0.8, P < .0001) and similar among AA (HR 1.1, 95% CI 0.95-1.41, P 5 .2). Among HS, there was a lower ACM among those residing in HS areas compared to those residing in a non-HS areas (HR 0.7 95% CI 0.56-0.9, P 5 .03) despite a lower median household income ($27,838 ± 3,328 vs $37,751 ± 17,036; P < .0001). This survival difference was not seen in CC and AA. Conclusion. Among patients referred for nuclear SPECT studies for suspected CAD, HS ethnicity was an independent predictor of a favorable prognosis. Among HS, the ethnic characteristic of patients' neighborhoods was an independent predictor of ACM. These results imply that ethnic social support is a potentially powerful modifier of patient outcomes among certain patient groups. (J Nucl Cardiol 2012;19:987-96.).

Original languageEnglish (US)
Pages (from-to)987-996
Number of pages10
JournalJournal of Nuclear Cardiology
Volume19
Issue number5
DOIs
StatePublished - Oct 1 2012
Externally publishedYes

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Single-Photon Emission-Computed Tomography
Hispanic Americans
Perfusion
Survival
Mortality
African Americans
Social Support

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Supariwala, Azhar ; Uretsky, Seth ; Singh, Padmakshi ; Memon, Salim H. ; Yeturi, Supraja ; Khokhar, Surinder S. ; Thothakura, Gargi ; Rozanski, Alan. / Impact of ethnic variation and residential segregation on long-term survival following myocardial perfusion SPECT. In: Journal of Nuclear Cardiology. 2012 ; Vol. 19, No. 5. pp. 987-996.
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abstract = "Background. Ethnic characteristics of a neighborhood may impact upon all-cause mortality (ACM). It is not known whether this consideration remains a risk modifier among those being evaluated for CAD. Methods. 6,477 pts (60 ± 13 years, male 38{\%}) residing in NYC with normal or abnormal stress SPECT studies were assessed for ACM during a mean follow-up of 9 ± 3.8 years. Baseline CAD risk factors and ethnic characteristics of patient neighborhoods were considered. Zip-codes with <70{\%} of one ethnicity was considered to be predominant of that ethnicity. Results. There were 573 (20{\%}) Hispanics (HS), 765 (27{\%}) African-Americans (AA), and 250 (30{\%}) Caucasians (CC) residing in areas <70{\%} of their own ethnicity. Compared to CC, the risk for ACM was lower in HS (hazard ratio (HR) 0.68, 95{\%} CI 0.57-0.8, P < .0001) and similar among AA (HR 1.1, 95{\%} CI 0.95-1.41, P 5 .2). Among HS, there was a lower ACM among those residing in HS areas compared to those residing in a non-HS areas (HR 0.7 95{\%} CI 0.56-0.9, P 5 .03) despite a lower median household income ($27,838 ± 3,328 vs $37,751 ± 17,036; P < .0001). This survival difference was not seen in CC and AA. Conclusion. Among patients referred for nuclear SPECT studies for suspected CAD, HS ethnicity was an independent predictor of a favorable prognosis. Among HS, the ethnic characteristic of patients' neighborhoods was an independent predictor of ACM. These results imply that ethnic social support is a potentially powerful modifier of patient outcomes among certain patient groups. (J Nucl Cardiol 2012;19:987-96.).",
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Impact of ethnic variation and residential segregation on long-term survival following myocardial perfusion SPECT. / Supariwala, Azhar; Uretsky, Seth; Singh, Padmakshi; Memon, Salim H.; Yeturi, Supraja; Khokhar, Surinder S.; Thothakura, Gargi; Rozanski, Alan.

In: Journal of Nuclear Cardiology, Vol. 19, No. 5, 01.10.2012, p. 987-996.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of ethnic variation and residential segregation on long-term survival following myocardial perfusion SPECT

AU - Supariwala, Azhar

AU - Uretsky, Seth

AU - Singh, Padmakshi

AU - Memon, Salim H.

AU - Yeturi, Supraja

AU - Khokhar, Surinder S.

AU - Thothakura, Gargi

AU - Rozanski, Alan

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N2 - Background. Ethnic characteristics of a neighborhood may impact upon all-cause mortality (ACM). It is not known whether this consideration remains a risk modifier among those being evaluated for CAD. Methods. 6,477 pts (60 ± 13 years, male 38%) residing in NYC with normal or abnormal stress SPECT studies were assessed for ACM during a mean follow-up of 9 ± 3.8 years. Baseline CAD risk factors and ethnic characteristics of patient neighborhoods were considered. Zip-codes with <70% of one ethnicity was considered to be predominant of that ethnicity. Results. There were 573 (20%) Hispanics (HS), 765 (27%) African-Americans (AA), and 250 (30%) Caucasians (CC) residing in areas <70% of their own ethnicity. Compared to CC, the risk for ACM was lower in HS (hazard ratio (HR) 0.68, 95% CI 0.57-0.8, P < .0001) and similar among AA (HR 1.1, 95% CI 0.95-1.41, P 5 .2). Among HS, there was a lower ACM among those residing in HS areas compared to those residing in a non-HS areas (HR 0.7 95% CI 0.56-0.9, P 5 .03) despite a lower median household income ($27,838 ± 3,328 vs $37,751 ± 17,036; P < .0001). This survival difference was not seen in CC and AA. Conclusion. Among patients referred for nuclear SPECT studies for suspected CAD, HS ethnicity was an independent predictor of a favorable prognosis. Among HS, the ethnic characteristic of patients' neighborhoods was an independent predictor of ACM. These results imply that ethnic social support is a potentially powerful modifier of patient outcomes among certain patient groups. (J Nucl Cardiol 2012;19:987-96.).

AB - Background. Ethnic characteristics of a neighborhood may impact upon all-cause mortality (ACM). It is not known whether this consideration remains a risk modifier among those being evaluated for CAD. Methods. 6,477 pts (60 ± 13 years, male 38%) residing in NYC with normal or abnormal stress SPECT studies were assessed for ACM during a mean follow-up of 9 ± 3.8 years. Baseline CAD risk factors and ethnic characteristics of patient neighborhoods were considered. Zip-codes with <70% of one ethnicity was considered to be predominant of that ethnicity. Results. There were 573 (20%) Hispanics (HS), 765 (27%) African-Americans (AA), and 250 (30%) Caucasians (CC) residing in areas <70% of their own ethnicity. Compared to CC, the risk for ACM was lower in HS (hazard ratio (HR) 0.68, 95% CI 0.57-0.8, P < .0001) and similar among AA (HR 1.1, 95% CI 0.95-1.41, P 5 .2). Among HS, there was a lower ACM among those residing in HS areas compared to those residing in a non-HS areas (HR 0.7 95% CI 0.56-0.9, P 5 .03) despite a lower median household income ($27,838 ± 3,328 vs $37,751 ± 17,036; P < .0001). This survival difference was not seen in CC and AA. Conclusion. Among patients referred for nuclear SPECT studies for suspected CAD, HS ethnicity was an independent predictor of a favorable prognosis. Among HS, the ethnic characteristic of patients' neighborhoods was an independent predictor of ACM. These results imply that ethnic social support is a potentially powerful modifier of patient outcomes among certain patient groups. (J Nucl Cardiol 2012;19:987-96.).

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