Am
Heart J 1999 Feb;137(2):338-45
Comment in:
Am Heart J. 1999 Feb;137(2):211-2.
Lower thrombolytic use for African Americans with myocardial infarction:
an influence of clinical presentation?
Borzak S, Joseph C, Havstad S, Tilley B, Smith ST, Housholder SD, Gheorghiade
M.
Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI,
USA. sborzak1@hfhs.org
BACKGROUND: After myocardial infarction, African Americans
have been reported to undergo fewer catheterization and revascularization
procedures than whites, but few studies have addressed racial variations
in the delivery of thrombolytic therapy.
METHODS: We conducted a retrospective analysis of data
prospectively collected on consecutive patients admitted with acute myocardial
infarction to the 16-bed coronary care unit of a large, urban teaching
hospital.
RESULTS: Over a 5-year period, 1948 consecutive patients
were admitted with acute myocardial infarction to a single coronary care
unit. Thrombolysis was administered to 19% of 1024 African Americans and
29% of 924 whites (P <.01). The initial diagnostic impression on admission
was "definite" infarction less often in African Americans (30%)
than in whites (43%, P <.001), a difference that appeared to largely
account for the difference in thrombolytic administration in a multivariable
model. Mortality adjusted for age and concomitant illnesses was similar
in African Americans compared with whites (relative risk 1.0, 95% confidence
interval 0.78 to 1.51).
CONCLUSIONS: Much of the racial variation in thrombolytic
administration could be accounted for by differences in clinical presentation,
an issue that requires further study.
PMID: 9924169 [PubMed - indexed for MEDLINE]
Am Heart J 1999 Feb;137(2):211-2
Comment on:
Am Heart J. 1999 Feb;137(2):338-45.
Understanding racial differences in the use of thrombolytic therapy:
what more do we need to know?
Maynard C.
Publication Types: Comment; Editorial
PMID: 9924152 [PubMed - indexed for MEDLINE]
