Clinical InvestigationAcute Ischemic Heart DiseaseReporting and representation of ethnic minorities in cardiovascular trials: A systematic review
Section snippets
Study selection
Our systematic review included studies published in The Journal of the American Medical Association (JAMA), The Lancet, and The New England Journal of Medicine (NEJM). These 3 medical journals were chosen because they have the highest impact factors and have been reported to have the most significant influence on clinical practice. This methodology of focusing on the highest impact journals was also consistent with several prior studies.10, 11 A standardized protocol was used for study
Results
A total of 250 major cardiovascular randomized clinical trials were included in our systematic review from 1997 to 2010 with recruitments of Americans. The attrition diagram for our literature search is shown in Figure 1. A total of 1,103,694 participants were enrolled in these trials. The mean age of the study participants was 63 years, and 35% were female. The majority of trials enrolled patients with coronary artery disease (58%) and evaluated drugs as an intervention (68%) (Table I).
Discussion
Our current systematic review of major contemporary cardiovascular trials extends previous findings of studies of racial representation in cardiovascular research. First, although we observed some improvements in the reporting of minority ethnic groups from 1997 to 2010, only about half of all studies reported any racial information of the enrolled patients. Second, we observed underenrollment of minority ethnic groups; but enrollment appeared to differ by ethnic groups in cardiovascular
Disclosures
Funding sources: Dr Ko is supported by a New Investigator Award from the Canadian Institutes of Health Research.
No conflicts of interest.
Acknowledgements
We are solely responsible for the design and conduct of this study, all study analyses, the drafting and editing of the paper, and its final contents.
Role of the sponsors
The results and conclusions are those of the authors and should not be attributed to any of the funding or sponsoring agencies. All decisions regarding study design, publication, and data analysis were made independent of the funding agencies.
References (16)
- et al.
Reporting and representation of race/ethnicity in published randomized trials
Am Heart J
(2009) - et al.
Enrollment in clinical trials according to patients race: experience from the VA Cooperative Studies Program (1975-2000)
Control Clin Trials
(2004) - et al.
Heart disease and stroke statistics—2010 update: a report from the American Heart Association
Circulation
(2010) - et al.
Racial differences in incident heart failure among young adults
N Engl J Med
(2009) - et al.
Association of race and sex with risk of incident acute coronary heart disease events
JAMA
(2012) - et al.
Sex and racial differences in the management of acute myocardial infarction, 1994 through 2002
N Engl J Med
(2005) - et al.
Racial trends in the use of major procedures among the elderly
N Engl J Med
(2005) - et al.
Ethnicity and socioeconomic status influencing use of primary angioplasty in patients presenting with acute myocardial infarction
Am Heart J
(2007)
Cited by (73)
Complete Percutaneous Coronary Revascularization in Acute Coronary Syndromes With Multivessel Coronary Disease: A Systematic Review
2023, JACC: Cardiovascular Interventions