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Clinical characteristics, process of care, and outcomes of Hispanic patients presenting with non-ST-segment elevation acute coronary syndromes: results from Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines (CRUSADE).
Am Heart J. 2006 Jul; 152(1):110-7.AH

Abstract

BACKGROUND

Data regarding the management of non-ST-segment elevation acute coronary syndromes (NSTE ACS) in Hispanic patients, the largest and fastest-growing minority in the United States, are scarce.

METHODS

We sought to describe the clinical characteristics, process of care, and outcomes of Hispanics presenting with NSTE ACS at US hospitals. We compared baseline characteristics, resource use, and inhospital mortality among 3936 Hispanics and 90280 non-Hispanic whites with NSTE ACS from the CRUSADE Quality Improvement Initiative.

RESULTS

The regional distribution of Hispanics in CRUSADE paralleled that in the US Census. Hispanics were younger (65 vs 70 years, P < .0001) and had less hyperlipidemia (45.4% vs 49.0%, P < .0001) but were more likely to be hypertensive (72.2% vs 67.9%, P < .0001) and diabetic (46.5% vs 30.9%, P < .0001). Hispanics were also more likely to be uninsured (12.5% vs 5.1%, P < .001). During hospitalization, Hispanics were more often managed conservatively, undergoing stress tests more frequently (13.0% vs 10.1%, P < .0001), with less use of cardiac catheterization within 48 hours (48.7% vs 55.5%, P < .0001) or percutaneous coronary intervention (39.6% vs 46.4%, P < .0001) at any time. Hispanics received similar discharge treatments but were less frequently referred for cardiac rehabilitation (38.5% vs 49.2%, P < .0001). Adjusted inhospital mortality was similar in both groups (odds ratio 0.87, 95% CI 0.72-1.05).

CONCLUSIONS

Although hispanics have a different risk factor profile and are treated less aggressively during hospitalization when they present with NSTE ACS, these treatment differences do not appear to affect inhospital outcomes. Further research is warranted to explore the long-term consequences of these findings.

Authors+Show Affiliations

Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7075, USA. mgcohen@med.unc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16824839

Citation

Cohen, Mauricio G., et al. "Clinical Characteristics, Process of Care, and Outcomes of Hispanic Patients Presenting With non-ST-segment Elevation Acute Coronary Syndromes: Results From Can Rapid Risk Stratification of Unstable Angina Patients Suppress ADverse Outcomes With Early Implementation of the ACC/AHA Guidelines (CRUSADE)." American Heart Journal, vol. 152, no. 1, 2006, pp. 110-7.
Cohen MG, Roe MT, Mulgund J, et al. Clinical characteristics, process of care, and outcomes of Hispanic patients presenting with non-ST-segment elevation acute coronary syndromes: results from Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines (CRUSADE). Am Heart J. 2006;152(1):110-7.
Cohen, M. G., Roe, M. T., Mulgund, J., Peterson, E. D., Sonel, A. F., Menon, V., Smith, S. C., Saucedo, J. F., Lytle, B. L., Pollack, C. V., Garza, L., Gibler, W. B., & Ohman, E. M. (2006). Clinical characteristics, process of care, and outcomes of Hispanic patients presenting with non-ST-segment elevation acute coronary syndromes: results from Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines (CRUSADE). American Heart Journal, 152(1), 110-7.
Cohen MG, et al. Clinical Characteristics, Process of Care, and Outcomes of Hispanic Patients Presenting With non-ST-segment Elevation Acute Coronary Syndromes: Results From Can Rapid Risk Stratification of Unstable Angina Patients Suppress ADverse Outcomes With Early Implementation of the ACC/AHA Guidelines (CRUSADE). Am Heart J. 2006;152(1):110-7. PubMed PMID: 16824839.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics, process of care, and outcomes of Hispanic patients presenting with non-ST-segment elevation acute coronary syndromes: results from Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines (CRUSADE). AU - Cohen,Mauricio G, AU - Roe,Matthew T, AU - Mulgund,Jyotsna, AU - Peterson,Eric D, AU - Sonel,Ali F, AU - Menon,Venu, AU - Smith,Sidney C,Jr AU - Saucedo,Jorge F, AU - Lytle,Barbara L, AU - Pollack,Charles V,Jr AU - Garza,Luis, AU - Gibler,W Brian, AU - Ohman,E Magnus, PY - 2005/06/29/received PY - 2005/09/07/accepted PY - 2006/7/11/pubmed PY - 2006/8/24/medline PY - 2006/7/11/entrez SP - 110 EP - 7 JF - American heart journal JO - Am Heart J VL - 152 IS - 1 N2 - BACKGROUND: Data regarding the management of non-ST-segment elevation acute coronary syndromes (NSTE ACS) in Hispanic patients, the largest and fastest-growing minority in the United States, are scarce. METHODS: We sought to describe the clinical characteristics, process of care, and outcomes of Hispanics presenting with NSTE ACS at US hospitals. We compared baseline characteristics, resource use, and inhospital mortality among 3936 Hispanics and 90280 non-Hispanic whites with NSTE ACS from the CRUSADE Quality Improvement Initiative. RESULTS: The regional distribution of Hispanics in CRUSADE paralleled that in the US Census. Hispanics were younger (65 vs 70 years, P < .0001) and had less hyperlipidemia (45.4% vs 49.0%, P < .0001) but were more likely to be hypertensive (72.2% vs 67.9%, P < .0001) and diabetic (46.5% vs 30.9%, P < .0001). Hispanics were also more likely to be uninsured (12.5% vs 5.1%, P < .001). During hospitalization, Hispanics were more often managed conservatively, undergoing stress tests more frequently (13.0% vs 10.1%, P < .0001), with less use of cardiac catheterization within 48 hours (48.7% vs 55.5%, P < .0001) or percutaneous coronary intervention (39.6% vs 46.4%, P < .0001) at any time. Hispanics received similar discharge treatments but were less frequently referred for cardiac rehabilitation (38.5% vs 49.2%, P < .0001). Adjusted inhospital mortality was similar in both groups (odds ratio 0.87, 95% CI 0.72-1.05). CONCLUSIONS: Although hispanics have a different risk factor profile and are treated less aggressively during hospitalization when they present with NSTE ACS, these treatment differences do not appear to affect inhospital outcomes. Further research is warranted to explore the long-term consequences of these findings. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/16824839/Clinical_characteristics_process_of_care_and_outcomes_of_Hispanic_patients_presenting_with_non_ST_segment_elevation_acute_coronary_syndromes:_results_from_Can_Rapid_risk_stratification_of_Unstable_angina_patients_Suppress_ADverse_outcomes_with_Early_implementation_of_the_ACC/AHA_Guidelines__CRUSADE__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(05)00848-3 DB - PRIME DP - Unbound Medicine ER -