# REasons for Geographic And Racial Differences in Stroke- Myocardial Infarction-3

> **NIH NIH R01** · WEILL MEDICAL COLL OF CORNELL UNIV · 2020 · $702,550

## Abstract

Despite marked declines, coronary heart disease (CHD) remains a leading cause of morbidity and mortality in
the US. To further decrease CHD, a better understanding of CHD risks and outcomes in the 21st century is
needed in light of: 1) continued health disparities; 2) declining ST elevation myocardial infarctions (MI); 3)
increasing sensitivity of troponin laboratory assays, increasing detection of very small and previously
undetectable MI events; 4) wide use of statins and revascularization procedures, complicating population
studies and risk prediction; 5) more people surviving their first MI; 6) increased emphasis on population health
management and patient-centeredness. The REasons for Geographic And Racial Differences in Stroke
(REGARDS) cohort includes 30,239 community-dwelling white and black participants recruited in 2003-2007.
In the previous 2 funding cycles, the REGARDS-MI ancillary study has produced >100 publications on racial
disparities in CHD and identified novel CHD risk factors. The REGARDS parent and other ancillary studies
have collected extensive phenotype, cardiovascular disease (CVD) risk factor, and patient-reported outcomes
data, including linked Medicare data. A second in-home visit is nearing completion, providing patient-centered
endpoints including quality of life up to 10 years following first MI. The availability of these novel data coupled
with >10 years of follow-up for all participants offers a unique opportunity to study CHD among high-risk
subpopulations, e.g., those with low socioeconomic status (SES), blacks, and older adults to identify strategies
to optimize population health while simultaneously eliminating health disparities. Our Specific Aims are to: 1)
Determine the 10-year incidence of CHD and CVD (either CHD or stroke) and examine associations with
traditional and emerging risk factors.
CHD events will be adjudicated using the same rigorous methods used
during the first 2 funding periods and combined with stroke events adjudicated through the parent REGARDS
study. We will refine published CHD and CVD risk prediction models and assess emerging risk factors in
subgroups (e.g., age, race, sex, and SES) and by MI type (very small or `microsize' MI, and type 2 MI). 2)
Develop pragmatic strategies to identify high-risk subgroups that could be targeted for interventions to optimize
population health while simultaneously eliminating health disparities.
We will calculate population attributable
risks and numbers of events potentially averted through population shifts in risk factor distributions. 3)
Determine the rates of, and risk factors for, recurrent CHD events, heart failure (HF), and mortality after first
adjudicated MI
(including very small, or `microsize' MI, and type 2 MI) or coronary revascularization procedure,
overall, and in subgroups (e.g., type of CHD event, age, race, sex, and SES). 4) Using data from the 2nd in-
home visit, describe patient-centered outcomes (functional status, depressive symp...

## Key facts

- **NIH application ID:** 9910226
- **Project number:** 5R01HL080477-14
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Emily B Levitan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $702,550
- **Award type:** 5
- **Project period:** 2006-06-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9910226

## Citation

> US National Institutes of Health, RePORTER application 9910226, REasons for Geographic And Racial Differences in Stroke- Myocardial Infarction-3 (5R01HL080477-14). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9910226. Licensed CC0.

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