Abstract 12647: Race and Gender Differences in Post-Myocardial Infarction Angina Frequency and Rehospitalization Risk
Background: Race and gender disparities in in-hospital treatment and outcomes of acute myocardial infarction (MI) patients have been described, yet little is known about race and gender differences in post-MI angina frequency and rehospitalization risk.
Methods: Among 11,595 MI patients treated with PCI during the index hospitalization who survived the first year post-discharge in the TRANSLATE-ACS study (2010–2012), we examined 6-week and 1-year angina frequency stratified by race and gender. We used multivariable logistic regression to assess factors associated with 1-year unplanned rehospitalization and assessed for interactions between angina status, race, and gender.
Results: Among 11,595 patients, there were 7,726 (66.6%) white males, 2,816 (24.3%) white females, 616 (5.3%) black males, and 437 (3.8%) black females. Comorbidities, including hypertension, diabetes, and heart failure, were most prevalent among black females, followed by black males, white females, and white males. Compared with white patients, black patients were significantly less likely to be angina-free at 6 weeks (female: 48.7% vs. 59.8%; male: 55.0% vs. 65.3%, both p<0.0001) and 12 months (female: 50.6% vs. 61.1%; male: 53.7% vs. 68.9%, both p<0.0001). As shown in the Figure, rates of 1-year unplanned rehospitalization were highest among black females (34.6%), followed by white females (31.3%), black males (30.0%), and white males (25.5%, p<0.0001). In the multivariable model, 6-week angina was the factor most strongly associated with 12-month unplanned rehospitalization (HR 1.40; 95% CI 1.28, 1.54; p<0.0001); this relationship was not modified by race or gender (both pinteraction>0.05).
Conclusions: Race and gender differences in post-MI angina frequency exist. Efforts to reduce post-MI rehospitalizations should target improvements in angina treatment.
Author Disclosures: C.N. Hess: Research Grant; Modest; Gilead Sciences, Inc.. L.A. McCoy: None. J. Doll: None. D.J. Cohen: None. E.D. Peterson: Research Grant; Significant; American College of Cardiology, American Heart Association, Eli Lilly & Company, Janssen Pharmaceuticals, Society of Thoracic Surgeons. Consultant/Advisory Board; Modest; Merck & Co.. Consultant/Advisory Board; Significant; Boehringer Ingelheim, Genentech, Janssen Pharmaceuticals, Sanofi-Aventis. T.Y. Wang: Research Grant; Significant; AstraZeneca, Gilead, Lilly, The Medicines Company, Canyon Pharmaceuticals. Consultant/Advisory Board; Modest; Medco. Consultant/Advisory Board; Significant; American College of Cardiology. Other; Modest; AstraZeneca.
- © 2015 by American Heart Association, Inc.