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African-American heart attack patients fare worse long term

tion rate of African-Americans in the trials from which the data was drawn is consistent with the historical range of 2 percent to 9 percent African-American participation of in other cardiology trials, Mehta said. African-Americans make up approximately 13 percent of the U.S. population.

"It has been shown that African-Americans are hesitant to participate in clinical trials and that there is a lack of trust in the medical profession, when compared to Caucasians," Mehta said. "This trend is seen more so in certain regions of the country."

Because of the historical under-representation of African-Americans in clinical trials, Mehta said that there is a paucity of data that might help explain the disparity in outcomes. He added that clinical trials involving large numbers of African-Americans will be required to gain reliable data on the epidemiology and biology of heart disease.

"Our data, combined with that gathered from previous studies, show a significant difference in the clinical features and patterns of care between African-Americans and Caucasians," Mehta said. "These differences, coupled with poorly understood genetic, biologic and other socio-economic factors appear to result in higher mortality rates for African-Americans.

"This data also shows that just treating the heart attack acutely may not be enough," he continued. "We also need to focus on improving such issues as compliance, access to care, and trust in the health care system."

The five clinical trials from which data was drawn were GUSTO-I, GUSTO-IIb, GUSTO-III, ASSENT-2 and ASSENT-3. Mehta's analysis was supported by the DCRI.


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Contact: Richard Merritt
Merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
9-Nov-2004


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