Racial Disparities Seen in Post-Heart Attack Outcomes
But disparities are attenuated after adjusting for patient characteristics that differ by race
TUESDAY, Mar. 3 (HealthDay News) -- In patients with myocardial infarction, overall outcomes are significantly worse in blacks than in whites. But the differences are attenuated after adjustment for patient characteristics that differ by race such as socioeconomic status and co-morbid conditions, researchers report in the Mar. 3 issue of the Annals of Internal Medicine.
John A. Spertus, M.D., of the Mid America Heart Institute in Kansas City, Mo., and colleagues compared outcomes in 1,849 patients (28 percent of them were black) who were treated at 10 hospitals nationwide and used the Seattle Angina Questionnaire to assess angina and quality of life.
In their unadjusted analysis, the researchers found that black patients had higher rates of mortality (19.9 percent versus 9.3 percent), rehospitalization (45.4 percent versus 40.4 percent) and angina (28 percent versus 17.8 percent), and a lower quality of life compared to whites. But after adjusting for patient characteristics, they found that these differences mostly disappeared and that black patients actually showed a trend toward lower rehospitalization. Adjustment for patient characteristics and further adjustment for site of care resulted in significantly attenuated mortality differences (hazard ratios, 1.29 and 1.04, respectively).
"Further adjustment for treatments received minimally influenced observed differences," the authors conclude. "Strategies that focus on improving baseline cardiac risk and hospital factors may do more than treatment-focused strategies to attenuate racial differences in myocardial infarction outcomes."
CV Therapeutics provided funding for the study. Spertus is the copyright holder of the Seattle Angina Questionnaire.