Heart Attack Treatment Differs by Race
Fewer Procedures, More Deaths for African-Americans, Study Shows
June 12, 2007 - After heart attacks, African-Americans get less open-heart surgery and fewer artery-unblocking procedures -- and are more likely to die -- than whites.
It's not ancient history. The finding comes from a contemporary analysis of the medical records of more than 1.2 million Medicare patients aged 68 and older. All of the patients had first heart attacks between 2000 and 2005.
Heart attacks happen when blood vessels supplying the heart muscle become blocked, leading to the death of parts of the heart muscle. For some patients, it's helpful to unblock these arteries -- either by bypass surgery or by balloon angioplasty.
These procedures work equally well for people of all races. Yet studies consistently find that African-American heart attack patients are significantly less likely to get these procedures than are white heart attack patients.
A new study led by Ioana Popescu, MD, MPH, of the Iowa City VA Medical Center and the University of Iowa, shows this racial disparity persists.
"Unfortunately, the differences we found were not small," Popescu tells WebMD.
Popescu and colleagues found that compared with white patients:
- When treated at hospitals that provide angioplasty and bypass surgery, African-American heart attack patients receive these services less often (34% vs. 50%).
- When treated at hospitals that do not provide these specialized heart services, African-American heart attack patients are less likely to be transferred to a hospital that does provide them (25% vs. 31%).
- "Even after transfer to a hospital that provided them, African-American patients were less likely to receive these services," Popescu says.
- While African-American heart attack patients are less likely to die in the month after their heart attack -- possibly due to the short-term risk posed by the procedures -- they are more likely to die within a year of their heart attack (37% vs. 33%).
"This study tells us there is a difference in quality of care for heart attack -- and it leads to a mortality difference," Giselle Corbie-Smith, MD, tells WebMD. Corbie-Smith, director of the program on health disparities at the University of North Carolina Sheps Center for Health Services Research, was not involved in the Popescu study.