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In women, revascularization rate varies by race, ethnicity

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Tarryn Tertulien

Black women with ACS or CHD less often receive revascularization compared with white and Hispanic women, according to findings presented at the American Heart Association Quality of Care & Outcomes Research Scientific Sessions.

Tarryn Tertulien, a fourth-year medical student at the Warren Alpert Medical School of Brown University, and colleagues sought to determine whether revascularization for ACS or CHD differed by race and socioeconomic factors starting in 2005, 3 years after the 2002 American College of Cardiology/AHA guidelines were published.

“There is a large body of literature that shows poorer health outcomes among marginalized groups,” Tertulien told Cardiology Today. “I was particularly interested in finding out whether the disparities improved over the years. The Women’s Health Initiative data set was ideal in that it allowed me to use prolonged follow-up time interval to analyze the pre- and post-2005 treatment rates among postmenopausal women.”

Tertulien and colleagues identified data from the Women’s Health Initiative to evaluate revascularization rates among 20,262 postmenopausal women (2,181 black, 572 Hispanic).

Revascularization rates increased during the 2 decades studied, but racial disparities did not narrow, the researchers wrote in an abstract.

Hispanic women with ACS or CHD had significantly lower rates of revascularization pre-2005 (HR = 0.77; 95% CI, 0.63-0.94) and a trend for lower rates post-2005 (HR = 0.93; 95% CI, 0.74-1.16) compared with white women, Tertulien and colleagues wrote.

Black women with ACS or CHD had less revascularization than white women before (HR = 0.5; 95% CI, 0.45-0.57) and after 2005 (HR = 0.5; 95% CI, 0.43-0.58), according to the researchers.

Black women with STEMI had a trend toward lower rates of revascularization before 2005 (HR = 0.85; 95% CI, 0.59-1.24), which reached statistical significance after 2005 (HR = 0.61; 95% CI, 0.38-0.98) compared with their white counterparts, the researchers wrote.

Women with low socioeconomic statuses with ACS or CHD had numerically lower rates of revascularization post-2005 compared with women with high socioeconomic status (HR = 0.91; 95% CI, 0.83-1.01), Tertulien and colleagues wrote.

Tertulien said additional research is needed to further understand factors at play.

“Awareness of these disparities is vital to clinical practice,” Tertulien told Cardiology Today. “I strongly believe that a better understanding of these disparities will allow providers and public health professionals to institute culturally sensitive interventions that are tailored towards these marginalized groups.” – by Earl Holland Jr.

Reference:

Tertulien T, et al. Poster 14. Presented at: American Heart Association Quality of Care & Outcomes Research Scientific Sessions; April 5-6, 2019; Arlington, Va.

Disclosures: Tertulien reports no relevant financial disclosures.