Abstract 20621: Ethnic Minorities and Use of Drug Eluting Stent in ST-Elevation Myocardial Infarction and Non-ST-Elevation Myocardial Infarction in the State of Florida
Background: Studies have reported that Black and Hispanics have lower rates of cardiovascular procedures. Patients with acute coronary syndrome (ACS) should not have health disparities. The aim of this study is to compare the use of drug eluding stents (DES) in ethnic minorities with an ST-elevation myocardial infarction (STEMI) and non-ST- elevation myocardial infarction (NSTEMI).
Methods: We conducted a cross-sectional analysis of all ambulatory and hospital discharge procedures between 2006 and 2009 in the State of Florida. We included all subjects using ICD-9 codes as STEMI (410.x) and NSTEMI (410.7). We classified them as Black, Hispanic and White and determine the use of DES using code 36.07. We used logistic regression to calculate the odds ratio (OR) and corresponding 95% confidence interval (CI) of DES by ethnicity adjusted for demographics, Charlson score and insurance.
Results: We identified 234,470 subjects with acute coronary syndrome (ACS). Twenty percent were Black or Hispanic and 75% had a NSTEMI. Blacks were younger and had the highest comorbidity scores compared with Whites and Hispanics (p<0.01). Patients with STEMI had a median DES use of 36% (27-37) compared to NSTEMI 14% (12-17). In STEMI, Blacks (27%) had less DES use compared with Whites (36%) and Hispanics (37%) (p<0.01). In NSTEMI, Blacks (12%) had less DES use compared with Whites (15%) and Hispanics (17%). The OR of having a DES for Blacks was 0.79 (95% CI 0.76-0.82) compared with Whites and the OR for Hispanics was 1.1 (95% CI 1.08-1.15). Death rates were similar among STEMI and NSTEMI groups as well as by ethnicity (p=0.34)
Conclusions: The results indicate that between 2006-2009, DES was less used in Black patients with ACS while Hispanics use more when compare to Whites. However, these differences do not appear to affect in-hospital mortality. Reasons for these disparities are not clear, further investigations are needed.
Author Disclosures: M.E. Mora Garzon: None. A. Palacio: None. L. Tamariz: None.
- © 2014 by American Heart Association, Inc.