Demographic and baseline data were collected for the 342 patients hospitalized during the period from September 1983 to October 1986 for myocardial infarction at Cook County Hospital in Chicago, Illinois. As the authors explain, “patients surviving the acute phase were discharged to the care of a general internist or cardiologist,” in which case “the medical care provided during this period was not standardized.” Cardiac catheterization was performed based on routine indications – 38 patients had angiography within the month of the index myocardial infarction and 22 patients had early coronary artery bypass grafting. Of the 285 black patients, 36 (12.7%) died in the period of their hospital stay, and 249 were discharged. Of the 249 discharged black patients, 41 died, 71% (29) of which died of reported cardiac causes. In a multivariate analysis, “only acute complications were associated with higher mortality after discharge (P, 0.001).”

Previous studies, the authors note, suggest that the high percentage (42%) of women in the study might account for the poor survival rate of this cohort. However, “mortality in both sexes was identical.” In addition, “diabetes, smoking, and particularly hypertension were frequent among our patients and may have contributed to the poor outcome.” Ultimately, “whatever the reasons for poor survival, it is urgent to make diagnosis and treatment of coronary disease for black patients equal with that available for white patients.”

The authors conclude that the “use of tertiary care in coronary artery disease by black patients is limited, and many patients in our cohort probably had less than optimal treatment and follow-up.”