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In adults with CAD, preventive medication use varies by race, ethnicity

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NEW ORLEANS — There is a disparity in the use of preventative medication among black and Hispanic adults with recurrent CAD compared with white adults, according to findings presented at the American College of Cardiology Scientific Session.

Magda Elizabeth Mora Garzon, MD, and colleagues sought to identify the ethnic disparity in secondary prevention therapy use prior to admission for acute MI among patients with prior CAD.

“The current guidelines recommend a secondary prevention therapy for patients with established coronary artery disease,” said Mora Garzon, of the University of Oklahoma. “However, recurrent coronary events are actually common. Noncompliance is questionable.”

Mora Garzon and colleagues analyzed data between 2011 and 2016 from the Chest Pain-MI registry consisting of patients with prior CAD presenting with acute MI. The researchers compared aspirin, statin and beta-blocker use among black and Hispanic patients prior to admission compared with white patients.

The researchers used multivariable logistic regression models to compare the association between race and medication use as well as in-hospital mortality.

Among the patients with prior CAD (n = 242,840; median age, 68 years; 70% men, 7% uninsured) in the cohort, 11% were black and 5% were Hispanic.

Hispanic and black patients were younger and more likely to be uninsured (P < .001), the researchers wrote.

Mora Garzon and colleagues found black and Hispanic patients were less likely to be to be on aspirin compared with white patients (white, 69.7%; black, 65.3%; Hispanic, 62.8%; P < .001). The difference persisted after multivariable adjustment (OR for black patients vs. white patients = 0.93; 95% CI, 0.89-0.96; OR for Hispanic patients vs. white patients = 0.83; 95% CI, 0.8-0.87).

In addition, Hispanic patients were less likely to be taking beta-blockers than white patients (63.2% vs. 60.6%; HR = 0.89; 95% CI, 0.85-0.93).

“Certainly, there are multiple other confounding factors and variables, not just on a patient level but a practice level, a consistent level that needs to be addressed in a study that can finally address compliance issues and disparity issues,” Mora Garzon said. – by Earl Holland Jr.

Reference:

Mora Garzon ME, et al. Cardiovascular Disease Prevention: Insights From Large Registries. Presented at: American College of Cardiology Scientific Session; March 16-18, 2019; New Orleans.

Disclosure: Mora Garzon reports no relevant financial disclosures.