Racial Disparities in Bypass Graft Outcomes in Women

To the Editor:I read with great interest the article by Roa-Vidal and Barron1 about coronary artery bypass grafts (CABGs) in female patients. The article summarized the diagnostic delay of coronary artery disease and the higher operative mortality rates for CABG in women.1 To provide quality health care to all patients, it is essential to further highlight the racial disparities in the aforementioned outcomes in women.Race-sex disparities have been extensively examined in health care more generally as well as in cardiovascular conditions specifically.2 Black women have been reported as presenting with a higher number of affected vessels, increased operative mortality following CABG, and longer hospital stays compared with White women.2 In addition to increasing age and comorbidities, being a Black woman has been reported as a risk factor for post-CABG hospital readmissions.3Higher cardiovascular operative mortality in female patients from racial minority groups has been associated with factors such as smaller coronary vasculature and lower rates of multiple artery revascularization.4 Other possible risk factors include reduced access to primary and preventative health care, a higher prevalence of comorbidities, suboptimal longitudinal follow-up appointments, and a lack of resources for physicians to provide care to female patients from marginalized racial and ethnic groups.5Improving access to health care, forming closer patient-clinician relationships, promoting open communication, and employing more targeted public health efforts may help close the racial disparity gap in post-CABG outcomes in women.2 Similarly, the development and incorporation of specific race-sex disparity resources associated with various medical conditions into the current medical curriculum is extremely important. Further studies on coronary artery disease and CABG outcomes for female patients from races and ethnicities other than non-Hispanic White, including Black, Asian, Hispanic, and American Indian or Alaska Native, are required. An increased focus on racial and ethnic disparities can assist in improving overall cardiovascular outcomes in female patients.