Perceived discrimination linked to worse outcomes after MI in younger patients
CHICAGO — In MI survivors younger than 55 years, those who reported perceived discrimination had worse outcomes in the year after their MI vs. those who did not, researchers reported at the American Heart Association Scientific Sessions.
“In recent years, there has been an increased focus on assessing social determinants of cardiovascular health disparities. Understanding the impact of perceived discrimination on post-acute MI outcomes is an important step in addressing barriers to health equity,” Andrew J. Arakaki, MPH, doctoral candidate in the department of chronic disease epidemiology at Yale School of Public Health, told Healio. “Previous studies have shown that older and middle-aged adults who reported more perceived discrimination were more likely to have cardiovascular disease risk factors (ie, hypertension) and had increased risk of having a heart attack. Young adults tend to report more discrimination, and little is known about whether perceived discrimination impacts recovery and outcomes after a heart attack.”
The researchers analyzed the health status at 1 month and 1 year of 2,670 patients with MI younger than 55 years from the VIRGO study. They determined perceived discrimination using the Everyday Discrimination Scale, general health using the SF-12 score and disease-specific health using four domains of the Seattle Angina Questionnaire score: quality of life, treatment satisfaction, physical limitation and angina frequency.
Approximately 35% of the cohort reported perceived discrimination as reflected by an Everyday Discrimination Scale score of more than 0.
At 1 month, an increased Everyday Discrimination Scale score was associated with lower SF-12 score, quality of life score and treatment satisfaction score and increased likelihood of physical limitation and angina, according to the researchers. Those associations remained consistent at 1 year except for treatment satisfaction score.
There was no relationship between perceived discrimination and SF-12 score.
“Everyday discrimination is a psychosocial stressor that is common among young adults with acute MI. Discrimination is independently associated with poor cardiac-specific outcomes during the first year of acute MI recovery and warrants attention when treating young adults hospitalized for acute MI,” Arakaki told Healio. “More research is needed to understand the mechanism underlying this association to identify appropriate targets for interventions.”
Collapse
Arakaki A, et al. Abstract 547. Presented at: American Heart Association Scientific Sessions; Nov. 5-7, 2022; Chicago (hybrid meeting).