Racial differences in the use of cardiac procedures in patients with acute myocardial infarction
Marjorie Funk1, Adrian M Ostfeld, Vicky M Chang
1Yale University School of Nursing, New Haven, CT 06536, USA. marjorie.funk@yale.edu
Insights
Black patients with acute myocardial infarction are less likely to receive cardiac angiography and revascularization compared to White patients. These disparities persist even after accounting for clinical and demographic factors.
Area of Science:
- Cardiology
- Health Disparities
- Medical Outcomes
Background:
- Existing research indicates racial disparities in cardiac procedure utilization.
- Previous studies often overlooked crucial clinical and demographic variables influencing these differences.
Purpose of the Study:
- To investigate racial disparities in coronary angiography and revascularization for acute myocardial infarction.
- To control for demographic and clinical factors in assessing these disparities.
Main Methods:
- Retrospective cohort study of 642 Black and White patients with acute myocardial infarction.
- Data collected from medical records at a southern New England cardiac referral center.
Main Results:
- Black patients were significantly less likely to undergo angiography and revascularization than White patients (adjusted ORs 0.36 and 0.21, respectively).
- Among patients admitted directly to the hospital, angiography rates were similar, but Black patients were less likely to receive revascularization (adjusted OR 0.18).
Conclusions:
- Substantial racial differences exist in the use of angiography and revascularization for acute myocardial infarction.
- These disparities are not explained by clinical or demographic factors, highlighting systemic issues.
Background:
Although numerous studies have shown that Black patients are less likely than White patients to undergo cardiac procedures, most of these studies did not consider clinical and demographic factors that could account for observed racial differences.
Objective:
To determine if there are racial differences in the use of coronary angiography and revascularization procedures in patients with acute myocardial infarction, while controlling for multiple potentially important demographic and clinical variables.
Methods:
In this retrospective cohort study, data were obtained from medical records of 642 consecutive Black and White patients with acute myocardial infarction at a regional cardiac referral center in southern New England.
Results:
Blacks were significantly less likely than Whites to undergo angiography (p =.004; adjusted odds ratio =.36; 95% confidence interval =.18 -.72) and revascularization procedures (p =.006; adjusted odds ratio =.21; 95% confidence interval =.07 -.64). In the subgroup admitted directly to the hospital (n = 465), rather than transferred in from outlying hospitals, there were no racial differences in the use of angiography, but Blacks were significantly less likely to undergo revascularization procedures (p =.004; adjusted odds ratio =.18; 95% confidence interval =.06 -.58).
Conclusions:
In patients hospitalized with acute myocardial infarction, there are substantial racial differences in the use of angiography and revascularization procedures that cannot be explained by clinical or demographic factors.
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