Sex and Racial Differences in the Management of Acute Myocardial Infarction, 1994 through 2002

• Published in: The New England journal of medicine Vol. 353; no. 7; pp. 671 - 682
• Main Authors: Vaccarino, Viola, Rathore, Saif S, Wenger, Nanette K, Frederick, Paul D, Abramson, Jerome L, Barron, Hal V, Manhapra, Ajay, Mallik, Susmita, Krumholz, Harlan M
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 18.08.2005
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Aged; Angioplasty; Aspirin - therapeutic use; Biological and medical sciences; Black or African American; Black People; Cardiology. Vascular system; Cardiovascular disease; Coronary Angiography - statistics & numerical data; Coronary heart disease; Female; General aspects; Health Services Accessibility; Heart; Heart attacks; Hospital Mortality; Hospitalization; Hospitals; Humans; Logistic Models; Male; Medical imaging; Medical sciences; Middle Aged; Myocardial Infarction - ethnology; Myocardial Infarction - therapy; Myocardial Revascularization - statistics & numerical data; Platelet Aggregation Inhibitors - therapeutic use; Process Assessment, Health Care; Quality of Health Care; Race; Racial differences; Risk Factors; Sex Factors; United States; White People; United States; Myocardial infarction; Acute; Sex; Cardiovascular disease; Male; Myocardial disease; Epidemiology; Ethnic group; Medicine; Clinical management; Treatment; 1994; Heart disease; 2002; Female; Comparative study; Empirical Approach; Health Care and Public Health
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMsa032214

This study compared treatments and outcomes after myocardial infarction according to sex and race from 1994 through 2002. As compared with white men, black men and both white and black women had lower rates of reperfusion therapy and coronary angiography, and black women had higher mortality. Sex and racial differences did not change substantially between 1994 and 2002. As compared with white men, black men and both white and black women had lower rates of reperfusion therapy and coronary angiography, and black women had higher mortality. In recent years, attention has been focused on variations in the treatment of coronary heart disease that are related to the sex and race of the patient. Landmark studies in the late 1980s and early 1990s reported differences in treatment according to sex and race. 1 – 4 In the past decade, other investigations have described a generally consistent pattern of less intensive treatment of acute myocardial infarction in women, as compared with men, 5 – 11 and in blacks, as compared with whites, 8 , 9 , 12 – 17 across a variety of settings. Efforts to remedy racial and sex differences in health care use have . . .