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    Genetic Admixture and Survival in Diverse Populations with Pulmonary Arterial Hypertension

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    PAH_Hispanic_Survival_12_20_19.pdf
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    Author
    Karnes, Jason H
    Wiener, Howard W
    Schwantes-An, Tae-Hwi
    Natarajan, Balaji
    Sweatt, Andrew J
    Chaturvedi, Abhishek
    Arora, Amit
    Batai, Ken
    Nair, Vineet
    Steiner, Heidi E
    Giles, Jason B
    Yu, Jeffrey
    Hosseini, Maryam
    Pauciulo, Michael W
    Lutz, Katie A
    Coleman, Anna W
    Feldman, Jeremy
    Vanderpool, Rebecca
    Tang, Haiyang
    Garcia, Joe G N
    Yuan, Jason X-J
    Kittles, Rick
    de Jesus Perez, Vinicio
    Zamanian, Roham T
    Rischard, Franz
    Tiwari, Hemant K
    Nichols, William C
    Benza, Raymond L
    Desai, Ankit A
    Show allShow less
    Affiliation
    Univ Arizona, Dept Epidemiol & Biostat
    Univ Arizona, Dept Med
    Univ Arizona, Dept Surg
    Univ Arizona, Dept Pharm Practice & Sci
    Issue Date
    2020-01-09
    Keywords
    Hispanic American
    native american
    health disparities
    pulmonary arterial hypertension
    Survival
    
    Metadata
    Show full item record
    Publisher
    AMER THORACIC SOC
    Citation
    Karnes, J. H., Wiener, H. W., Schwantes-An, T. H., Natarajan, B., Sweatt, A. J., Chaturvedi, A., ... & Giles, J. B. (2020). Genetic admixture and survival in diverse populations with pulmonary arterial hypertension. American Journal of Respiratory and Critical Care Medicine, 201(11), 1407-1415.
    Journal
    AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
    Rights
    Copyright © 2020 by the American Thoracic Society.
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Rationale: Limited information is available on racial/ethnic differences in pulmonary arterial hypertension (PAH). Objectives: Determine effects of race/ethnicity and ancestry on mortality and disease outcomes in diverse patients with PAH. Methods: Patients with Group 1 PAH were included from two national registries with genome-wide data and two local cohorts, and further incorporated in a global meta-analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for transplant-free, all-cause mortality in Hispanic patients with non-Hispanic white (NHW) patients as the reference group. Odds ratios (ORs) for inpatient-specific mortality in patients with PAH were also calculated for race/ethnic groups from an additional National Inpatient Sample dataset not included in the meta-analysis. Measurements and Main Results: After covariate adjustment, self-reported Hispanic patients (n = 290) exhibited significantly reduced mortality versus NHW patients (n = 1,970) after global meta-analysis (HR, 0.60 [95% CI, 0.41-0.87]; P = 0.008). Although not significant, increasing Native American genetic ancestry appeared to account for part of the observed mortality benefit (HR, 0.48 [95% CI, 0.23-1.01]; P= 0.053) in the two national registries. Finally, in the National Inpatient Sample, an inpatient mortality benefit was also observed for Hispanic patients (n = 1,524) versus NHW patients (n = 8,829; OR, 0.65 [95% CI, 0.50-0.84]; P = 0.001). An inpatient mortality benefit was observed for Native American patients (n = 185; OR, 0.38 [95% CI, 0.15-0.93]; P= 0.034). Conclusions: This study demonstrates a reproducible survival benefit for Hispanic patients with Group 1 PAH in multiple clinical settings. Our results implicate contributions of genetic ancestry to differential survival in PAH.
    Note
    12 month embargo; published online: 9 January 2020
    ISSN
    1073-449X
    PubMed ID
    31916850
    DOI
    10.1164/rccm.201907-1447OC
    Version
    Final accepted manuscript
    ae974a485f413a2113503eed53cd6c53
    10.1164/rccm.201907-1447OC
    Scopus Count
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    UA Faculty Publications

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