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Blacks less likely to get expensive, newer heart treatments

  • 8.1 percent of black patients underwent coronary bypass surgery, compared to 12.1 percent of white patients.
  • At discharge, 41.6 percent of black patients were prescribed clopidogrel, compared to 53.7 percent of white patients.
  • Cholesterol-lowering drugs called statins were used 70.9 percent of the time in black patients compared to 74.9 percent in white patients.
  • Blacks were also less likely to receive smoking cessation counseling.

    "Despite these disparities, we did not find any significant difference in short-term outcomes," Sonel said. "The death rate and combined incidence of death and post admission heart attack were about the same between blacks and whites. However, our data were limited to adverse outcomes that occurred prior to discharge, and we do not know the long-term implications of these disparities."

    Researchers considered possible reasons for these disparities in treatment, such as patient demographic and clinical characteristics, provider specialty, and a variety of hospital factors. "However, racial differences in treatments persisted even after adjustment for these factors," Sonel said. "Other possible explanations for the observed disparities that were not assessed as part of this study include patient preferences, physician knowledge and attitudes, including the potential for racial bias, and styles of doctor-patient communication."

    The investigators suggest future research efforts in this area should focus on a better understanding of why these disparities exist, what the long-term implications are for such disparities, and the best methods to implement evidence-based guidelines so that all clinicians have the blueprint for treatment of non-ST-elevation acute coronary syndrome and such racial disparities can be eliminated.

    "If everyone is well aware of the evidence and treats every patient according to these recommendations, these disparities may be eliminated," Sonel said.

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  • Contact: Carole Bullock
    carole.bullock@heart.org
    214-706-1279
    American Heart Association
    15-Mar-2005


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