What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Ischemic heart disease (acute myocardial infarction or unstable angina) (n=91767). Intervention: American Indian/Alaska Native race vs. Non-Hispanic white race. Primary outcome: Receipt of cardiac catheterization (OR 0.95, 95% CI 0.82-1.10).

January 26, 2010Journal of General Internal MedicineOpen Access

Cardiac Procedures among American Indians and Alaska Natives compared to Non-Hispanic Whites Hospitalized with Ischemic Heart Disease in California

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Key result

American Indians and Alaska Natives hospitalized for ischemic heart disease had similar odds of receiving cardiac catheterization compared to non-Hispanic whites (adjusted OR 0.95).

Why the study?

Does American Indian/Alaska Native race/ethnicity affect the rate of cardiac procedures in patients hospitalized for ischemic heart disease compared to non-Hispanic whites?

Population

91,767 hospitalizations for ischemic heart disease in patients aged ≥30 years in 37 counties in California…

Comparison

American Indian/Alaska Native race/ethnicity vs Non-Hispanic white race/ethnicity

Design

Cross-sectional

Authors

SJStacey E. JollyCleveland Clinic CKChi KaoUniversity of Auckland ABAndrew B. BindmanKaiser Permanente

Discussion

Member takes

Implication

Similar catheterization rates in California should not yet change practice; leaves open national disparities or other procedures.

Study Design

Type

Cross-Sectional (n=91,767)

Multicenter

Yes

Structured PICO

Does American Indian/Alaska Native race/ethnicity affect the rate of cardiac procedures in patients hospitalized for ischemic heart disease compared to non-Hispanic whites?

Population

91,767 hospitalizations for ischemic heart disease among adults aged 30 and older in California, comparing American Indians/Alaska Natives to non-Hispanic whites.

Exposure

American Indian/Alaska Native (AIAN) race/ethnicity

Comparator

Non-Hispanic white race/ethnicity

Outcome

Receipt of cardiac catheterization, percutaneous coronary intervention, or coronary artery bypass graft surgery during hospitalization

Main Result

Odds Ratio: 0.95 (95% CI 0.82–1.1)

Absolute Event Rate: 40.9% vs 40.8%

In California, American Indians and Alaska Natives hospitalized for ischemic heart disease received cardiac catheterization and percutaneous coronary intervention at similar rates to non-Hispanic whites.

Limitations

Analysis is based on administrative data, which may have reliability issues with racial coding.
The unit of analysis is hospitalizations rather than individuals, which could mask disparities if one group has multiple hospitalizations.
Cannot account for clinical appropriateness or severity of disease using administrative data.
Cannot account for patients who may have been offered a cardiac procedure and subsequently refused.
Based on administrative data with potential racial misclassification
Unit of analysis is hospitalizations, not individuals
Cannot account for clinical appropriateness (underuse vs overuse)
Cannot account for patient refusal of procedures
Lacked key clinical information such as number of atherosclerotic vessels

Cite This Study

Jolly et al. (2010) conducted a cross-sectional in Ischemic heart disease (acute myocardial infarction or unstable angina) (n=91,767). American Indian/Alaska Native race vs. Non-Hispanic white race was evaluated on Receipt of cardiac catheterization (OR 0.95, 95% CI 0.82-1.10). American Indians and Alaska Natives hospitalized for ischemic heart disease had similar odds of receiving cardiac catheterization compared to non-Hispanic whites (adjusted OR 0.95).

synapsesocial.com/papers/6a20a6cd8b0daa6b96cd306f https://doi.org/10.1007/s11606-009-1235-y

Topics

Women and heart disease

View Full Paper

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January 26, 2010Journal of General Internal MedicineOpen Access

Cardiac Procedures among American Indians and Alaska Natives compared to Non-Hispanic Whites Hospitalized with Ischemic Heart Disease in California

View Full Paper

Ask AI

Bookmark

Key result

American Indians and Alaska Natives hospitalized for ischemic heart disease had similar odds of receiving cardiac catheterization compared to non-Hispanic whites (adjusted OR 0.95).

Why the study?

Does American Indian/Alaska Native race/ethnicity affect the rate of cardiac procedures in patients hospitalized for ischemic heart disease compared to non-Hispanic whites?

Population

91,767 hospitalizations for ischemic heart disease in patients aged ≥30 years in 37 counties in California…

Comparison

American Indian/Alaska Native race/ethnicity vs Non-Hispanic white race/ethnicity

Design

Cross-sectional

Authors

SJStacey E. JollyCleveland Clinic CKChi KaoUniversity of Auckland ABAndrew B. BindmanKaiser Permanente

Discussion

Member takes

Implication

Similar catheterization rates in California should not yet change practice; leaves open national disparities or other procedures.

Study Design

Type

Cross-Sectional (n=91,767)

Multicenter

Yes

Structured PICO

Does American Indian/Alaska Native race/ethnicity affect the rate of cardiac procedures in patients hospitalized for ischemic heart disease compared to non-Hispanic whites?

Population

91,767 hospitalizations for ischemic heart disease among adults aged 30 and older in California, comparing American Indians/Alaska Natives to non-Hispanic whites.

Exposure

American Indian/Alaska Native (AIAN) race/ethnicity

Comparator

Non-Hispanic white race/ethnicity

Outcome

Receipt of cardiac catheterization, percutaneous coronary intervention, or coronary artery bypass graft surgery during hospitalization

Main Result

Odds Ratio: 0.95 (95% CI 0.82–1.1)

Absolute Event Rate: 40.9% vs 40.8%

Limitations

Analysis is based on administrative data, which may have reliability issues with racial coding.
The unit of analysis is hospitalizations rather than individuals, which could mask disparities if one group has multiple hospitalizations.
Cannot account for clinical appropriateness or severity of disease using administrative data.
Cannot account for patients who may have been offered a cardiac procedure and subsequently refused.
Based on administrative data with potential racial misclassification
Unit of analysis is hospitalizations, not individuals
Cannot account for clinical appropriateness (underuse vs overuse)
Cannot account for patient refusal of procedures
Lacked key clinical information such as number of atherosclerotic vessels

Cite This Study

synapsesocial.com/papers/6a20a6cd8b0daa6b96cd306f https://doi.org/10.1007/s11606-009-1235-y

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Topics

Women and heart disease

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