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Published on: March 27, 2018
Racial disparities in outcomes following coronary artery bypass grafting
Marilyn Hravnak1, Said Ibrahim, Abigail Kaufer
1School of Nursing, University of Pittsburgh, Pittsburgh, Pa 15261, USA. mhra@pitt.edu
Insights
African Americans with coronary heart disease are less likely to receive invasive treatment like coronary artery bypass grafting (CABG). Further research is needed to understand the causes of disparities in CABG outcomes for Black patients.
Area of Science:
- Cardiovascular Medicine
- Health Disparities Research
- Surgical Outcomes Analysis
Background:
- Coronary heart disease (CHD) affects over 12 million Americans, with African Americans experiencing higher prevalence.
- Despite higher CHD rates, Black individuals undergo fewer invasive cardiac interventions, including coronary artery bypass grafting (CABG).
- Black patients exhibit increased morbidity and mortality following CABG compared to other racial groups.
Purpose of the Study:
- To review existing literature on health and healthcare disparities in Black patients with CHD concerning CABG.
- To explore potential hypotheses and contributing factors to racial variations in post-CABG surgical outcomes.
Main Methods:
- Literature review and synthesis of existing research on racial disparities in CHD and CABG.
- Examination of individual, provider, systemic, and societal/environmental factors potentially influencing outcomes.
Main Results:
- Data indicates significant racial disparities in the utilization of CABG for CHD treatment among Black patients.
- Evidence suggests higher adverse outcomes, including morbidity and mortality, post-CABG in the Black population.
- The precise causes for these outcome variations remain incompletely understood.
Conclusions:
- Racial disparities exist in both the application of CABG and its subsequent outcomes for patients with coronary heart disease.
- Further investigation into the multifactorial causes of these disparities is crucial for improving care equity.
- Addressing these disparities requires a comprehensive approach considering various contributing factors.
Abstract:
More than 12 million people in the United States have coronary heart disease, the second leading cause of hospitalization in the United States. It is known that persons within racial minorities, specifically African Americans, have a higher prevalence of coronary heart disease, yet are much less likely to undergo invasive cardiac treatment interventions. An invasive intervention commonly used to treat coronary heart disease is coronary artery bypass grafting, with over 140,000 operations performed annually in the United States. However, blacks are known to experience higher post-coronary artery bypass graft morbidity and mortality. The causes for racial disparities in post-coronary artery bypass graft outcomes are not well known but may include factors related to the individual, provider, system, and society/environment, either alone or in combination. The purpose of this article is to provide an overview of the literature regarding disparities in the health and healthcare of black patients with coronary heart disease with respect to CABG, and examine potential hypotheses for variant outcomes after surgery.
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