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. 1995 May;87(5):339–344.

Outcomes in African-American women with suspected acute myocardial infarction: the Myocardial Infarction Triage and Intervention Project.

C Maynard 1, N R Every 1, P E Litwin 1, J S Martin 1, W D Weaver 1
PMCID: PMC2607799  PMID: 7783240

Abstract

Increasing attention has been given to the investigation of cardiovascular disease in women, although African-American women have received little attention. This study compares characteristics and outcomes in women admitted to coronary care units for suspected acute myocardial infarction (MI). Between January 1988 and December 1991, a total of 554 (5%) African-American and 9738 (95%) white women with suspected acute MI were admitted to coronary care units in metropolitan Seattle, Washington. Relevant demographic socioeconomic, clinical, and outcome data were abstracted from the medical record and entered in the Myocardial Infarction Triage and Intervention registry. African-American women were younger, more often single and unemployed, and were less likely to have health insurance than their white counterparts. In addition, a higher proportion of African-American women reported a history of hypertension and diabetes mellitus. After adjustment for age, African-American women were equally as likely to develop acute MI and were more likely to die in the hospital. In addition, a higher proportion of African-American women were readmitted to coronary care units for suspected MI. Compared with their white counterparts, African-American women with suspected acute MI were considerably worse off from both socioeconomic and clinical standpoints, and their relative disadvantage was apparent in poor outcomes.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ayanian J. Z., Epstein A. M. Differences in the use of procedures between women and men hospitalized for coronary heart disease. N Engl J Med. 1991 Jul 25;325(4):221–225. doi: 10.1056/NEJM199107253250401. [DOI] [PubMed] [Google Scholar]
  2. Ayanian J. Z., Udvarhelyi I. S., Gatsonis C. A., Pashos C. L., Epstein A. M. Racial differences in the use of revascularization procedures after coronary angiography. JAMA. 1993 May 26;269(20):2642–2646. [PubMed] [Google Scholar]
  3. Bickell N. A., Pieper K. S., Lee K. L., Mark D. B., Glower D. D., Pryor D. B., Califf R. M. Referral patterns for coronary artery disease treatment: gender bias or good clinical judgment? Ann Intern Med. 1992 May 15;116(10):791–797. doi: 10.7326/0003-4819-116-10-791. [DOI] [PubMed] [Google Scholar]
  4. Cowie M. R., Fahrenbruch C. E., Cobb L. A., Hallstrom A. P. Out-of-hospital cardiac arrest: racial differences in outcome in Seattle. Am J Public Health. 1993 Jul;83(7):955–959. doi: 10.2105/ajph.83.7.955. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hallstrom A., Boutin P., Cobb L., Johnson E. Socioeconomic status and prediction of ventricular fibrillation survival. Am J Public Health. 1993 Feb;83(2):245–248. doi: 10.2105/ajph.83.2.245. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Khan S. S., Nessim S., Gray R., Czer L. S., Chaux A., Matloff J. Increased mortality of women in coronary artery bypass surgery: evidence for referral bias. Ann Intern Med. 1990 Apr 15;112(8):561–567. doi: 10.7326/0003-4819-112-8-561. [DOI] [PubMed] [Google Scholar]
  7. Krumholz H. M., Douglas P. S., Lauer M. S., Pasternak R. C. Selection of patients for coronary angiography and coronary revascularization early after myocardial infarction: is there evidence for a gender bias? Ann Intern Med. 1992 May 15;116(10):785–790. doi: 10.7326/0003-4819-116-10-785. [DOI] [PubMed] [Google Scholar]
  8. Liao Y., Cooper R. S., Ghali J. K., Szocka A. Survival rates with coronary artery disease for black women compared with black men. JAMA. 1992 Oct 14;268(14):1867–1871. [PubMed] [Google Scholar]
  9. Maynard C., Litwin P. E., Martin J. S., Cerqueira M., Kudenchuk P. J., Ho M. T., Kennedy J. W., Cobb L. A., Schaeffer S. M., Hallstrom A. P. Characteristics of black patients admitted to coronary care units in metropolitan Seattle: results from the Myocardial Infarction Triage and Intervention Registry (MITI). Am J Cardiol. 1991 Jan 1;67(1):18–23. doi: 10.1016/0002-9149(91)90092-y. [DOI] [PubMed] [Google Scholar]
  10. Maynard C., Litwin P. E., Martin J. S., Weaver W. D. Gender differences in the treatment and outcome of acute myocardial infarction. Results from the Myocardial Infarction Triage and Intervention Registry. Arch Intern Med. 1992 May;152(5):972–976. [PubMed] [Google Scholar]
  11. Steingart R. M., Packer M., Hamm P., Coglianese M. E., Gersh B., Geltman E. M., Sollano J., Katz S., Moyé L., Basta L. L. Sex differences in the management of coronary artery disease. Survival and Ventricular Enlargement Investigators. N Engl J Med. 1991 Jul 25;325(4):226–230. doi: 10.1056/NEJM199107253250402. [DOI] [PubMed] [Google Scholar]
  12. Tobin J. N., Wassertheil-Smoller S., Wexler J. P., Steingart R. M., Budner N., Lense L., Wachspress J. Sex bias in considering coronary bypass surgery. Ann Intern Med. 1987 Jul;107(1):19–25. doi: 10.7326/0003-4819-107-1-19. [DOI] [PubMed] [Google Scholar]
  13. Weaver W. D., Eisenberg M. S., Martin J. S., Litwin P. E., Shaeffer S. M., Ho M. T., Kudenchuk P., Hallstrom A. P., Cerqueira M. D., Copass M. K. Myocardial Infarction Triage and Intervention Project--phase I: patient characteristics and feasibility of prehospital initiation of thrombolytic therapy. J Am Coll Cardiol. 1990 Apr;15(5):925–931. doi: 10.1016/0735-1097(90)90218-e. [DOI] [PubMed] [Google Scholar]

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