Revascularization underused in postmenopausal Black women with acute MI
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Among postmenopausal women with acute MI, Black women were less likely to receive revascularization, particularly PCI, compared with white women, researchers reported.
Tarryn Tertulien, MD, MSc, internal medicine resident at the University of Pittsburgh Medical Center, and colleagues conducted an analysis of 5,284 postmenopausal women from the Women’s Health Initiative study who had acute MI from 1993 to 2019. As Healio previously reported, the researchers found in 2018 that in a larger sample of women from the Women’s Health Initiative study with ACS or CHD, Black women were less likely to receive revascularization than white or Hispanic women.
The cohort included 9.5% Black women, 87.7% white women and 23.2% with income less than $20,000 per year.
Compared with white women, Black women were less likely to receive revascularization for acute MI (adjusted HR = 0.79; 95% CI, 0.66-0.95), Tertulien and colleagues found.
The results were driven by PCI (aHR = 0.72; 95% CI, 0.59-0.9), and there was no difference by race in odds of receiving CABG (aHR = 0.97; 95% CI, 0.72-1.32).
There was no difference between Hispanic women and white women in likelihood of receiving revascularization for acute MI (aHR = 1.07; 95% CI, 0.82-1.38), according to the researchers.
Compared with women with income of $20,000 per year or more, those with income of less than $20,000 per year had lower odds of receiving revascularization for acute MI (aHR = 0.9; 95% CI, 0.82-0.99), the researchers wrote.
Revascularization rates did not change from the period before 2010 to the period after 2010, the researchers wrote.
“Our findings suggest that race and income merit consideration in the complex management of acute MI,” Tertulien and colleagues wrote. “Additional investigation with patients, community stakeholders and health care professionals is needed to develop timely interventions that invoke anti-racist principles.”
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