Racial and Ethnic Disparities in Acute Coronary Syndrome: A Nationally Representative Sample

Area of Science:

• Cardiology
• Health Services Research
• Health Equity

Background:

• Significant disparities in acute coronary syndrome (ACS) outcomes are observed across racial and ethnic groups.
• Contemporary data is needed to evaluate resource utilization and inpatient outcomes in diverse populations.

Purpose of the Study:

• To assess disparities in resource utilization and inpatient outcomes for acute coronary syndrome (ACS) across racial and ethnic groups.
• To analyze differences in in-hospital complications, length of stay, and total hospital charges.

Main Methods:

• Utilized the National Inpatient Sample (NIS) database for hospital discharges related to ACS in the United States from 2015 to 2018.
• Employed International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes to identify key variables.
• Performed statistical analysis using STATA version 17.

Main Results:

• Included 1,911,869 ACS discharges: 78.6% White, 12.1% Black, 9.3% Hispanic.
• Hispanic and Black patients were younger with more cardiometabolic comorbidities (hypertension, diabetes, obesity) than White patients.
• Hispanic patients incurred higher total hospital charges; Black patients were least likely to undergo revascularization.
• White patients exhibited higher in-hospital mortality rates compared to Black and Hispanic patients.

Conclusions:

• Despite higher comorbidity burden and socioeconomic challenges, Black and Hispanic patients demonstrated lower in-hospital mortality rates for ACS than White patients.
• Hispanic patients faced the highest total hospital charges per ACS admission.
• Findings highlight complex disparities in ACS care, resource use, and outcomes across racial and ethnic lines.