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Blacks less likely to get expensive, newer heart treatments

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In this study, researchers reviewed data comparing how 37,813 white and 5,504 black high-risk patients with this syndrome were treated compared to the recommendations in the joint guidelines. The patient information was culled from the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines?) database an ongoing, voluntary national quality improvement program at more than 400 hospitals nationwide.

The review showed that black high-risk patients were typically younger, female and more likely to have high blood pressure, diabetes, heart failure, and renal insufficiency than white patients. Black patients were also less likely to have insurance coverage or have a cardiologist as their primary health care provider during hospitalization.

Researchers found that high-risk blacks were as likely or more likely than whites to receive older and more established treatments such as aspirin, beta blockers, ACE inhibitors, and heparin for acute care, but were significantly less likely to receive newer drugs both on presentation and at discharge.

"Clopidogrel, glycoprotein IIb/IIIa inhibitors, and cardiac catheterization were underused in both groups, but were used much less commonly in the acute care phase among black patients compared to white patients," Sonel said.

Other study findings included:

  • 29.2 percent of black patients received glycoprotein IIb/IIIa inhibitors within 24 hours compared to 35.7 percent of white patients.
  • 32.1 percent of black patients received clopidogrel within 24 hours compared to 40.6 percent of white patients.
  • 36.3 percent of black patients received cardiac catheterization within 48 hours of hospitalization compared to 49 percent of white patients.
  • 17.5 percent of black patients received angioplasty within 48 hours, while 29.3 percent of white patients had the procedure within 48 hours.
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
15-Mar-2005


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