Heart attack patients who are black are less likely than white patients to undergo procedures to reopen blocked arteries. A new study reveals treatments and survival rates differ between races.
Black patients had lower rates of revascularization procedures, like angioplasty, in the 30 days after a heart attack than white patients, report researchers from the University of Iowa Carver College of Medicine. Black patients were also less likely to be transferred from hospitals with no access to these procedures to hospitals with full coronary revascularization services.
Researcher Ioana Popescu, M.D., Ph.D., told Ivanhoe the exact reasons for these racial differences cannot be learned from this study. However, where patients lived and which medical centers they were closest to did not seem to have an impact. “No matter what type of hospital these black patients were treated at, they were less likely to receive procedures. So we don’t think it’s a matter of where you go, it’s a matter of what happens once you’re there,” Dr. Popescu said.
Although black patients were more likely to survive the 30-day period after a heart attack than white patients, black patients had a lower survival rate at one year.
“One explanation for that is there is actually overuse [of procedures] in white patients. These treatments have mortality risks inherently,” explained Dr. Popescu. Whether or not revascularization procedures should be used on a patient depends on several factors, including severity of blockage. Many determining factors were not included in the date used for this study. “So it’s very hard to say that black patients need to be treated more aggressively because we couldn’t control for appropriate use of procedures.”
Previous studies have shown similar disparities in the post-heart attack care of blacks, including several studies that focused on comparisons of ideal clinical candidates for revascularization. Dr. Popescu said more research is needed to uncover the reasons for the differenced, and patients can improve their odds by doing what they can to prevent heart disease and learning about treatment options.
SOURCE: Ivanhoe interview with Ioana Popescu, M.D., Ph.D.; The Journal of the American Medical Association, 2007;297:2489-2495