News

Gender, Race Gaps Shown in MI Care


 

ATLANTA — Women with acute MI are roughly one-third less likely than are men to undergo cardiac catheterization and coronary revascularization procedures, a trend that has persisted since the mid-1980s, William J. Kostis, Ph.D., said at the annual meeting of the American College of Cardiology.

Similarly, African Americans with an MI—men as well as women—are roughly one-quarter less likely than are whites to get a revascularization procedure. And again, that trend has held constant since the mid-1980s, said Dr. Kostis of Robert Wood Johnson Medical School, Piscataway, N.J.

These were among the findings of an analysis of nearly 248,000 first MIs in New Jersey during 1986–2002. The data were collected through the state's Myocardial Infarction Data Acquisition System (MIDAS), which includes information on all patients admitted with acute MI to nonfederal hospitals.

The rate of revascularization by percutaneous coronary intervention or coronary artery bypass surgery was less than 10% in both men and women with acute MI in 1986. In men, the rate climbed steadily to 54% by 2002, but in women it reached 34% in the mid-1990s and then leveled off.

Coronary revascularization was less than 10% among African Americans and whites in 1986, but by 2002 it rose to 46% among whites, and to 38% in African Americans. Adjusted 30-day mortality following first MI was significantly greater in women than in men, and in African Americans than in whites. But after further adjustment for rates of procedures, the increased mortality risk in women and African Americans was diminished; it became statistically nonsignificant in African Americans. This implies the lesser use of procedures in these groups is causally related to their higher mortality.

Bruce Jancin

Recommended Reading

Class of Antihypertensive Unimportant if It Works
MDedge Family Medicine
Studies Bring New Focus to Hormone Therapy : A novel progestin with antialdosterone effects is being developed to help treat postmenopausal symptoms.
MDedge Family Medicine
Acupuncture Therapy Cuts Mild Hypertension, but Not for Long
MDedge Family Medicine
Gender May Factor Into ICD Efficacy
MDedge Family Medicine
Statins Improve Renal Function in Heart Patients
MDedge Family Medicine
Lipid-Lowering Drug Benefits Similar for Diabetics
MDedge Family Medicine
MI Presents as Chest Pain in 44% Of Renal Patients
MDedge Family Medicine
SSRIs Cut Depression Scores in Heart Failure
MDedge Family Medicine
Post-Myocardial Infarction Depression Severity Stabilizes After 6 Months
MDedge Family Medicine
Ultrafiltration Bests Loop Diuretics in Acute HF : The FDA-approved device allows fluid to be extracted from a patient's blood at a controlled rate.
MDedge Family Medicine