Related Experiment Video
Updated: Oct 4, 2026
Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023
Coronary artery bypass grafting in Native Americans: a higher risk of death compared to other ethnic groups?
B K Nallamothu1, S Saint, S Saha
1Department of Internal Medicine, University of Michigan Medical School, Ann Arbor 48109-0022, USA. bnallamo@umich.edu
Insights
Coronary artery bypass grafting (CABG) may pose a higher in-hospital death risk for Native Americans compared to other ethnic groups. Further research is needed to confirm these findings in this population.
Area of Science:
- Cardiovascular Surgery
- Health Disparities
- Ethnic Health Outcomes
Background:
- Coronary artery bypass grafting (CABG) is a well-established procedure.
- Limited data exists on CABG outcomes specifically for Native Americans.
Purpose of the Study:
- To investigate ethnic differences in clinical outcomes following CABG.
- To assess in-hospital mortality and length of stay among Native Americans undergoing CABG.
Main Methods:
- Analysis of a national database including 18,061 patients from 25 U.S. healthcare facilities.
- Classification of patients into five ethnic groups: Native American, white, African American, Hispanic, and Asian.
- Statistical adjustment for age, gender, surgical priority, case-mix severity, insurance, and facility characteristics.
Main Results:
- Native Americans exhibited a significantly higher adjusted risk for in-hospital death compared to white, African American, Hispanic, and Asian patients.
- Odds ratios for in-hospital death ranged from 2.8 to 7.1 across comparisons with other ethnic groups.
- No significant ethnic differences were observed in the length of stay post-CABG.
Conclusions:
- The risk of in-hospital mortality after CABG may be elevated in Native Americans.
- Further research with larger sample sizes is necessary to validate these findings due to the limited number of Native American patients in the study.
Background:
While the efficacy and safety of coronary artery bypass grafting (CABG) has been established in several clinical trials, little is known about its outcomes in Native Americans.
Measurements And Main Results:
We assessed clinical outcomes associated with CABG in 155 Native Americans using a national database of 18,061 patients from 25 nongovernmental, not-for-profit U.S. health care facilities. Patients were classified into five groups: 1) Native American, 2) white, 3) African American, 4) Hispanic, and 5) Asian. We evaluated for ethnic differences in in-hospital mortality and length of stay, and after adjusting for age, gender, surgical priority, case-mix severity, insurance status, and facility characteristics (volume, location, and teaching status). Overall, we found the adjusted risk for in-hospital death to be higher in Native Americans when compared to whites (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.5 to 9.8), African Americans (OR, 3.4; 95% CI, 1.1 to 9.9), Hispanics (OR, 7.1; 95% CI, 2.5 to 20.3), and Asians (OR, 2.8; 95% CI, 1.1 to 7.0). No significant differences were found in length of stay after adjustment across ethnic groups.
Conclusions:
The risk of in-hospital death following CABG may be higher in Native Americans than in other ethnic groups. Given the small number of Native Americans in the database (n = 155), however, further research will be needed to confirm these findings.
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease IV: Preventive Measures
01:26Coronary Artery Disease II: Pathophysiology