OBJECTIVE
To assess participation bias in the assembly of a specimen repository for genetic
studies and to examine the association of participation with outcome within the Olmsted
County myocardial infarction (MI) cohort.
PARTICIPANTS AND METHODS
From January 1, 1979, to May 31, 2006, 3081 persons had MI in Olmsted County, MN.
Face-to-face contact was used to recruit patients who were hospitalized for an acute
event. Persons who had had an MI before establishment of this repository were contacted
by mail. At initial contact, we sought consent to use blood samples for genetic studies.
Persons who refused were contacted by mail and were asked to consent to the use of
stored tissue samples. For deceased subjects, stored tissue was collected when available.
RESULTS
Of the 3081 persons in the Olmsted County MI cohort, 1994 participated in the study;
1007 (50.5%) blood and 987 (49.5%) tissue specimens were provided. Participants were
more likely to be younger men with hypertension, comorbidities, and non-ST-segment
elevation MI (all, P<.05). Participants who provided blood specimens were more likely to have non-ST-segment
elevation MI and lower Killip class than those who provided tissue. After adjustment
for age, sex, hypertension, ST-segment elevation, Killip class, and comorbidities,
participation was not associated with outcome. Participants who provided blood specimens
were less likely to have heart failure (hazard ratio, 0.49; 95% confidence interval,
0.40-0.59; P<.01) or to die (hazard ratio, 0.16; 95% confidence interval, 0.12-0.21; P<.01) than those who provided tissue.
CONCLUSIONS
A variety of sources can be used to assemble community specimen repositories. Baseline
characteristics differed between participants and nonparticipants and, among participants,
by specimen source. Participants who provided blood specimens had better outcomes
than those who provided tissue specimens. No survival advantage was observed for participants
after combining blood and tissue specimens.
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Article Info
Footnotes
This study was supported by a Clinician Investigator Fellowship Award from Mayo Clinic and grants from the Public Health Service and the National Institutes of Health ( AR30582, R01 HL59205, and R01 HL72435 ). Dr Roger is an Established Investigator of the American Heart Association.
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© 2007 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
