Differential Use of Coronary Revascularization and Hospital Mortality Following Acute Myocardial Infarction

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Abstract
ISCHEMIC HEART DISEASE is the leading cause of death among all Americans.1 Blacks with coronary heart disease experience higher rates of mortality compared with whites and Hispanics.2,3 Reasons for this disparity are still uncertain. Possible explanations include the distribution of risk factors for coronary heart disease such as hypertension and diabetes mellitus, delayed diagnosis of acute ischemia, differences in access to high-quality health care, and discrimination.2-9 Perhaps related to mortality are disparities by race/ethnicity in the use of diagnostic and therapeutic cardiac procedures, such as coronary angiography and revascularization.10-17 Blacks and Hispanics have been reported to be less likely to undergo coronary angiography and revascularization than whites. However, the effect of racial disparity in the use of cardiac procedures on short-term outcomes, such as hospital mortality among diverse patient populations, is limited.9,18-20