Changes in Use of Diagnostic Procedures for Heart Attack

Differences observed since 1987; differs based on gender and race

MONDAY, April 28 (HealthDay News) -- Among patients hospitalized with myocardial infarction since 1987, mortality rates and the use of some diagnostic procedures have changed with time and differ based on gender and race, according to study findings published in the May issue of the American Journal of Cardiology.

Camille A. Pearte, M.D., from the National Heart, Lung, and Blood Institute in Bethesda, Md., and colleagues analyzed patient characteristics, rates of procedure use and outcomes from 11,242 adults (aged 35 to 74 years) from four geographically diverse U.S. communities, who were hospitalized with myocardial infarction between 1987 and 2001.

The researchers found substantial increases in the use of angiography, higher use of echocardiography in women, and lower use of right-sided cardiac catheterization, but similar usage of nuclear scans and exercise tests over this period. Women without a history of myocardial infarction had fewer angiograms and more echocardiograms than men. Blacks without a history of myocardial infarction were less likely than whites to undergo angiography compared with those with a history of myocardial infarction. Men and women had similar adjusted mortality rates, but blacks had higher mortality than whites, although this was reduced after adjusting for angiography use, the report indicates.

"In conclusion, in patients hospitalized with myocardial infarction, use of many diagnostic cardiovascular procedures varied over time, with differences by gender, age, race and geography that persisted over time unexplained by many measurable characteristics," Pearte and colleagues write.

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