Racial/Ethnic Differences in CHD Outcomes Not Due to Statins
(HealthDay News) — For hospitalized patients with coronary heart disease (CHD), racial and ethnic differences in one-year outcomes are due to demographics and comorbidity, not differential statin prescriptions, according to a study published in the February 1 issue of The American Journal of Cardiology.
Heidi Mochari-Greenberger, PhD, MPH, from Columbia University Medical Center in New York City, and colleagues examined the correlation between race and ethnicity, statin prescriptions, and clinical outcomes among 3,067 hospitalized patients (35% black or Hispanic; 65% white or Asian) with preexisting CHD. Electronic medical records, National Death Index, and/or standardized surveys were used to extract baseline clinical and medication data and 30-day and one-year outcomes.
The researchers found that, compared with white and Asian patients, black and Hispanic patients were significantly more likely to be dead or rehospitalized at one year (odds ratio, 1.23) and were significantly less likely to report pre-admission statin use (62 versus 72%; odds ratio, 0.64). At discharge, statin prescriptions were similar for blacks and Hispanics (81%) compared with whites and Asians (84%). Compared with whites and Asians, blacks and Hispanics were more likely to have hypertension, diabetes, or renal failure, and were less likely to have health insurance (P<0.05). Demographics and comorbidities, but not differential statin prescription, accounted for the increased one-year odds of death or rehospitalization in minorities versus whites and Asians (adjusted odds ratio, 1.10; 95% confidence interval, 0.93 to 1.30).
"Efforts to reduce CHD rehospitalizations should consider the greater burden of comorbidities among racial and ethnic minorities," the authors conclude.