Racial Variation in the Use of Coronary-Revascularization Procedures — Are the Differences Real? Do They Matter?

• Published in: The New England journal of medicine Vol. 336; no. 7; pp. 480 - 486
• Main Authors: Peterson, Eric D, Shaw, Linda K, DeLong, Elizabeth R, Pryor, David B, Califf, Robert M, Mark, Daniel B
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 13.02.1997
• Subjects: African Americans; Angioplasty, Balloon, Coronary - statistics & numerical data; Biological and medical sciences; Black or African American; Black People; Cardiology; Cardiovascular disease; Coronary Artery Bypass - statistics & numerical data; Coronary Disease - ethnology; Coronary Disease - mortality; Coronary Disease - surgery; Coronary Disease - therapy; Coronary vessels; Heart attacks; Heart surgery; Hospitals, University - statistics & numerical data; Humans; Intubation; Logistic Models; Medical sciences; North Carolina; Patient Selection; Practice Patterns, Physicians' - statistics & numerical data; Prognosis; Race; Racial differences; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Rate; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; White People; North Carolina; Human; Treatment; Angioplasty; Surgery; Surgical revascularization; Race; Cardiovascular disease; Coronary heart disease; Comparative study; Empirical Approach; Professional Patient Relationship; Duke University Medical Center
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199702133360706

Numerous studies have reported racial differences in the use of cardiac procedures. 1 – 15 These studies have often relied on medical-claims data, however, which do not contain important clinical information needed to identify patients with coronary artery disease accurately and adjust for differences in the severity of disease. 16 For instance, if blacks had less extensive coronary disease, fewer symptoms, or fewer coexisting illnesses, then lower rates of coronary-revascularization procedures would be expected. In addition, these studies generally could not determine the effect of differences in treatment on outcomes in patients. The potential benefits of coronary revascularization can be measured in terms . . .