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