Abstract TMP53: Mexican Americans and Non-Hispanic Whites Have Different Prestroke Comorbidity Profiles: Results From the Brain Attack Surveillance in Corpus Christi Project

Abstract

Introduction: Multiple comorbid conditions (MCC) explain variation in stroke outcomes beyond the damage caused by the stroke. Mexican Americans (MAs) and non-Hispanic Whites (NHWs) may have a different spectrum and severity of MCC, which may contribute to ethnic differences in stroke outcomes. We sought to determine the clustering of MCC in ischemic stroke patients as well as ethnic differences. Methods: MA and NHWs with ischemic stroke (2008-2017) from the Brain Attack Surveillance in Corpus Christi Project were studied. Twenty-two prestroke comorbidities (prevalence >1%) were identified using ICD codes and medical records from acute hospitalizations. Latent class analysis was used to identify comorbidity clusters (class). Multinomial logistic regression was used to assess age-adjusted ethnic differences in class membership. Results: Of 1,670 patients, 49% were male, 68% were MA, mean age was 69 (SD=13). MAs were younger, more likely to be obese, and have hypertension, diabetes, and renal and liver failure, but less likely to have arrhythmia and chronic pulmonary disease. Three latent classes were identified (Figure). Class 1 had a high prevalence of uncomplicated hypertension and diabetes but low prevalence of other comorbidities. Class 2 and 3 had similarly higher prevalence for most comorbidities, except that the prevalence of renal failure, and complicated hypertension and diabetes in Class 2 and arrhythmia in Class 3 were relatively higher. Compared with NHWs, MAs were more likely to be in Class 1 (OR 1.72, 95%CI: 1.15-2.56) and Class 2 (OR 2.18, 95%CI: 1.63-3.10) versus Class 3. Conclusion: Distinct MCC clusters, patterned by ethnicity, were identified. Efforts to target specific minority populations to reduce stroke disparities may benefit from addressing the ethnic-specific MCC clusters.