Racial disparities in diagnostic evaluation and revascularization in patients with acute myocardial infarction-a fifteen-year longitudinal study


Aurora Sinai/Aurora St. Luke's Medical Centers


We aimed to evaluate longitudinal trends of racial and ethnic disparities in the utilization of diagnostic angiograms, percutaneous coronary intervention (PCI), and coronary artery bypass graft surgery (CABG) for non-ST elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI). We retrospectively analyzed the National Inpatient Sample (2005-2019). The fifteen-year period was divided into five, three-year periods. Our study included 9 million adult patients (NSTEMI, 72%; STEMI, 28%). No improvement in utilization of these procedures was seen in period 5 (2017-2019) vs. period 1 (2005-2007) for both NSTEMI and STEMI in non-White patients vs. White patients (P>.05 for all comparisons), excepting in CABG for STEMI in Black patients vs. White patients (difference in CABG rate: period 1, 2.6%; period 5, 1.4%; P=.03). Reducing disparities in PCI for NSTEMI and both PCI and CABG for STEMI in Black patients vs. White patients was associated with improved outcomes.



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