Minority Health Archive

Black–White Differences in Severity of Coronary Artery Disease Among Individuals with Acute Coronary Syndromes

Whittle, Jeff and Conigliaro, Joseph and Good, C Bernie and Hanusa, Barbara H and Macpherson, David S (2002) Black–White Differences in Severity of Coronary Artery Disease Among Individuals with Acute Coronary Syndromes. Journal of General Internal Medicine, 17 (11). pp. 876-882.

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OBJECTIVE To determine whether the extent of coronary obstructive disease is similar among black and white patients with acute coronary syndromes. DESIGN Retrospective chart review. PATIENTS We used administrative discharge data to identify white and black male patients, 30 years of age or older, who were discharged between October 1, 1989 and September 30, 1995 from 1 of 6 Department of Veterans Affairs (VA) hospitals with a primary diagnosis of acute myocardial infarction (AMI) or unstable angina (UnA) and who underwent coronary angiography during the admission. We excluded patients if they did not meet standard clinical criteria for AMI or UnA or if they had had prior percutaneous transluminal coronary angioplasty or coronary artery bypass grafting. MEASUREMENTS AND MAIN RESULTS Physician reviewers classified the degree of coronary obstruction from blinded coronary angiography reports. Obstruction was considered significant if there was at least 50% obstruction of the left main coronary artery, or if there was 70% obstruction in 1 of the 3 major epicardial vessels or their main branches. Of the 628 eligible patients, 300 (48%) had AMI. Among patients with AMI, blacks were more likely than whites to have no significant coronary obstructions (28/145, or 19%, vs 10/155 or 7%, P = .001). Similarly, among patients with UnA, 33% (56/168) of blacks but just 17% (27/160) of whites had no significant stenoses (P = .012). There were no racial differences in severity of coronary disease among veterans with at least 1 significant obstruction. Racial differences in coronary obstructions remained after correcting for coronary disease risk factors and characteristics of the AMI. CONCLUSIONS Black veterans who present with acute coronary insufficiency are less likely than whites to have significant coronary obstruction. Current understanding of coronary disease does not provide an explanation for these differences.

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Item Type: Article
Additional Information: This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions.
Uncontrolled Keywords: coronary atherosclerosis, race, acute myocardial infarction, unstable angina, acute coronary syndromes
Subjects: Health > Health Equity
Health > Public Health > Chronic Illness & Diseases > Cardiovascular Disease
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Depositing User: Users 141 not found.
Date Deposited: 07 Apr 2011
Last Modified: 08 Jul 2011 09:02
Link to this item (URI): http://health-equity.lib.umd.edu/id/eprint/1316

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