Department of Quantitative Health Sciences; Department of Medicine, Division of Cardiovascular Medicine; Department of Medicine, Division of Geriatric Medicine; Meyers Primary Care Institute
Cardiology | Cardiovascular Diseases | Epidemiology | Health Services Administration | Pathological Conditions, Signs and Symptoms | Preventive Medicine | Race and Ethnicity
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.
Acute coronary syndromes, Longitudinal study, Race and geographic differences
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© 2017 The Authors. Published by Elsevier Inc.
DOI of Published Version
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
Preventive medicine reports
Goldberg RJ, Gore JM, McManus DD, McManus RH, Tisminetzky M, Lessard DM, Gurwitz JH, Parish DC, Allison JJ, Hess CN, Wang T, Kiefe CI. (2017). Race and place differences in patients hospitalized with an acute coronary syndrome: Is there double jeopardy? Findings from TRACE-CORE. UMass Chan Medical School Faculty Publications. https://doi.org/10.1016/j.pmedr.2017.01.010. Retrieved from https://escholarship.umassmed.edu/faculty_pubs/1210
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