Heart Attack Care Depends On Race and Sex

Same situation, but different
treatment in heart attack care
© Picture Disk

One of the largest national studies on the topic, the research showed that use of clinically recommended treatments, including aspirin, beta-blockers and reperfusion therapy (use of a drug or invasive catheter procedure to open an artery blocked by a clot) were lower in women and black patients with a heart attack. Some of these differences were explained by other patient characteristics.

Additionally, cardiac catheterisation, a diagnostic procedure used to identify blockages in the heart's circulation commonly performed in patients after a heart attack, was also used less frequently in women and black patients with a heart attack.

"What concerns me most is that we found persistence of an elevated risk of death among African American women," said senior author Harlan M. Krumholz, M.D., professor of medicine and public health at Yale School of Medicine. "This finding, along with evidence of differences in treatment, requires attention and remedy."

The authors used data from the National Registry of Myocardial Infarction-3 and -4, a registry of 589,911 patients hospitalised for heart attacks throughout the United States between 1994 and 2002. The team evaluated whether race and sex differences in treatment that had been previously reported in heart attack care had changed in subsequent years.

"Lower rates of treatment in patients who are clinically appropriate for treatment are troubling and raise obvious concerns about under-treatment," said first author Viola Vaccarino, M.D., associate professor of cardiology and epidemiology at Emory University. "Differences in treatment were not explained by patient age, risk factors or other clinical characteristics that might differ between patients. We simply could not determine the reasons for these differences."

MEDICA.de; Source: Yale University