Blacks Less Likely to Get Angioplasty After Heart Attack

By Amanda Gardner
HealthDay Reporter
Tuesday, June 12, 2007; 12:00 AM

TUESDAY, June 12 (HealthDay News) -- A new U.S. study finds that black Medicare patients who have a heart attack are less likely than whites to get procedures that open their blood vessels, such as angioplasty, which can leave them more vulnerable to dying within a year.

The study used recent data to confirm and update knowledge of racial disparities persisting in the health care system.

"We found some significant differences, and definitely, we have no good explanation for why," said lead researcher Dr. Ioana Popescu, health services researcher at Iowa City VA Medical Center. "More research needs to be done."

The study is published in the June 13 issue of theJournal of the American Medical Association.

"This study uses a contemporary cohort, following patients through 2005, and this is the first study to look at that," said Popescu, who is also a junior faculty member at the University of Iowa Carver College of Medicine in Iowa City.

The study also differs from previous research in that it stratifies patients by hospital type, meaning those that do and do not provide specialized heart services.

Prior studies have indicated that racial differences in care after a heart attack appear most pronounced when it comes to invasive and costly technologies such as coronary revascularization or procedures to get the blood flowing again to the heart.

The most common type of revascularization is coronary artery bypass graft (CABG).

Some recent studies have suggested that differing access to high-quality providers might account for some racial disparities.

Less than one-fifth of U.S. acute-care hospitals provide coronary revascularization, and many Medicare beneficiaries are initially admitted to hospitals that don't provide CABG or percutaneous coronary intervention (PCI, formerly known as angioplasty).

Few studies have looked at such patterns of care and how they might impact disparities.

For this study, the authors looked at more than 1.2 million black and white Medicare beneficiaries aged 68 and older who had been admitted to one of 4,627 U.S. hospitals between 2000 and 2005 with a heart attack. The hospitals were mixed, some having revascularization services and some not.

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