Race and place differences in patients hospitalized with an acute coronary syndrome: Is there double jeopardy? Findings from TRACE-CORE
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Authors
Goldberg, Robert J.Gore, Joel M.
McManus, David D.
McManus, Richard H.
Tisminetzky, Mayra
Lessard, Darleen M.
Gurwitz, Jerry H.
Parish, David C.
Allison, Jeroan J.
Hess, Connie Ng
Wang, Tracy
Kiefe, Catarina I.
UMass Chan Affiliations
Meyers Primary Care InstituteDepartment of Medicine, Division of Geriatric Medicine
Department of Medicine, Division of Cardiovascular Medicine
Department of Quantitative Health Sciences
Document Type
Journal ArticlePublication Date
2017-01-24Keywords
Acute coronary syndromesLongitudinal study
Race and geographic differences
Cardiology
Cardiovascular Diseases
Epidemiology
Health Services Administration
Pathological Conditions, Signs and Symptoms
Preventive Medicine
Race and Ethnicity
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The objectives of this longitudinal study were to examine differences between whites and blacks, and across two geographical regions, in the socio-demographic, clinical, and psychosocial characteristics, hospital treatment practices, and post-discharge mortality for hospital survivors of an acute coronary syndrome (ACS). In this prospective cohort study, we performed in-person interviews and medical record abstractions for patients discharged from the hospital after an ACS at participating sites in Central Massachusetts and Central Georgia during 2011-2013. Among the 1143 whites in Central Massachusetts, 514 whites in Central Georgia, and 277 blacks in Central Georgia, we observed a gradient of socioeconomic position with whites in Central Massachusetts being the most privileged, followed by whites and then blacks from Central Georgia; similar gradients pertained to psychosocial vulnerability (e.g., 10.7%, 25.1%, and 49.1% had cognitive impairment, respectively) and to the hospital receipt of all 4 evidence-based cardiac medications (35.5%, 18.1%, and 14.4%, respectively) used in the acute management of patients hospitalized with an ACS. Multivariable adjusted odds ratios (95% confidence intervals) for the receipt of a percutaneous coronary intervention for whites and blacks in Georgia vs. whites in Massachusetts were 0.57 (0.46-0.71) and 0.40(0.30-0.52), respectively. Thirty-day and one-year mortality risks exhibited a similar gradient. The results of this contemporary clinical/epidemiologic study in a diverse patient cohort suggest that racial and geographic disparities continue to exist for patients hospitalized with an ACS.Source
Prev Med Rep. 2017 Jan 24;6:1-8. doi: 10.1016/j.pmedr.2017.01.010. eCollection 2017. Link to article on publisher's site
DOI
10.1016/j.pmedr.2017.01.010Permanent Link to this Item
http://hdl.handle.net/20.500.14038/28984PubMed ID
28210536Related Resources
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© 2017 The Authors. Published by Elsevier Inc.Distribution License
http://creativecommons.org/licenses/by-nc-nd/4.0/ae974a485f413a2113503eed53cd6c53
10.1016/j.pmedr.2017.01.010
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Except where otherwise noted, this item's license is described as © 2017 The Authors. Published by Elsevier Inc.