Abstract P161: Improved Gender and Racial-Ethnic Disparities in the Management of Acute Myocardial Infarction. Experience from a Community Hospital Serving a Large Hispanic Population in USA
Introduction: Disparities in medical therapies and revascularization procedures have been reported for women and Hispanics in the management of Acute Myocardial Infarction (AMI) in USA.
Objectives: A paucity of recent data on this subject from facilities with a large Hispanic patient (pts) base motivated this study.
Methods: Records of consecutive 525 pts (55% women, 289 of 525) admitted between 2005-2007 with a suspected AMI to a Southern California non-profit Community Hospital.
Results: Race/ethnicity was unknown in 40 pts; 48%, 252 of 525, were Hispanic; 30 %, 155 of 525, Non Hispanic Whites and 14%, 78 of 525, African-Americans and Asians. No gender differences in age (66.9±14.8), diabetes, hypertension, dyslipidemia, medical insurance were found. Men had more AMI (93%, 219 of 236 v/s 51%, 147 of 289, p<0.001), death (7.6%, 18 of 238 v/s 3.8%, 11 of 289, p<0.05), smoking, CATH, PTCA and CABG than women. However, there were no gender or Hispanic ethnicity differences in the proportion of procedures performed when an AMI was confirmed (Fig1). Hispanic women (HW) showed no differences in death, AMI, CATH, CABG and Stress Test as compared to Non Hispanic White Women (NHWW) with the exception of PTCA (31%, 22 of 71, vs. 50%, 21 of 42, p <0.03). A trend (NS) for more AMI in NHWW and CABG in HW was noted. Non Hispanic Whites had more private/commercial insurance than Hispanics (61%, 95 of 155 vs. 32.1%, 81 of 252, p<0.01), regardless of gender. No differences were found in the composite (admission, discharge) use of ASA/Antiplatelets, B-blockers, ACEI /ARB and lipid lowering treatment.
Conclusions: No Gender and Hispanic race/ethnicity disparities in the management of AMI were found for most services. HW received less PTCA than NHWW, difference that may be multifactorial. Medical insurance inequalities between Non Hispanic Whites and Hispanics persist but apparently did not affect the AMI care. It is uncertain if these results are applicable to facilities in USA with different socioeconomic, racial/ethnic mix or resources.
- © 2012 by American Heart Association, Inc.