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Meta-Analysis of Racial Disparity in Outcomes of Acute Myocardial Infarction

      There have been concerns that Black patients may be at risk for poorer outcomes after an acute myocardial infarction (AMI), compared with White patients, because of decreased access to quality care and a lower likelihood of receiving evidence-based cardiovascular interventions.
      • Blackston JW
      • Safford MM
      • Mefford MT
      • Freeze E
      • Howard G
      • Howard VJ
      • Naftel DC
      • Brown TM
      • Levitan EB.
      Cardiovascular disease events and mortality after myocardial infarction among Black and White adults: REGARDS study.
      • Mathews R
      • Chen AY
      • Thomas L
      • Wang TY
      • Chin CT
      • Thomas KL
      • Roe MT
      • Peterson ED.
      Differences in short-term versus long-term outcomes of older black versus white patients with myocardial infarction: findings from the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of American College of Cardiology/American Heart Association Guidelines (CRUSADE).
      • Singh JA
      • Lu X
      • Ibrahim S
      • Cram P.
      Trends in and disparities for acute myocardial infarction: an analysis of Medicare claims data from 1992 to 2010.
      However, individual studies have shown conflicting results, with some demonstrating poorer outcomes after AMI in Black patients,
      • Blackston JW
      • Safford MM
      • Mefford MT
      • Freeze E
      • Howard G
      • Howard VJ
      • Naftel DC
      • Brown TM
      • Levitan EB.
      Cardiovascular disease events and mortality after myocardial infarction among Black and White adults: REGARDS study.
      ,
      • Skinner J
      • Chandra A
      • Staiger D
      • Lee J
      • McClellan M.
      Mortality after acute myocardial infarction in hospitals that disproportionately treat black patients.
      whereas others suggest no difference between the 2 racial groups.
      • Mathews R
      • Chen AY
      • Thomas L
      • Wang TY
      • Chin CT
      • Thomas KL
      • Roe MT
      • Peterson ED.
      Differences in short-term versus long-term outcomes of older black versus white patients with myocardial infarction: findings from the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of American College of Cardiology/American Heart Association Guidelines (CRUSADE).
      ,
      • Ng DK
      • Brotman DJ
      • Lau B
      • Young JH.
      Insurance status, not race, is associated with mortality after an acute cardiovascular event in Maryland.
      ,
      • Huckfeldt P
      • Escarce J
      • Sood N
      • Yang Z
      • Popescu I
      • Nuckols T.
      Thirty-day postdischarge mortality among black and white patients 65 years and older in the Medicare Hospital Readmissions Reduction Program.
      It is essential to identify racial disparities in outcomes to develop policies designed to ensure equity and delivery of care and outcomes. Therefore, we sought to conduct a meta-analysis of available studies to examine whether mortality after AMI differs between Black and White patients.
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      References

        • Blackston JW
        • Safford MM
        • Mefford MT
        • Freeze E
        • Howard G
        • Howard VJ
        • Naftel DC
        • Brown TM
        • Levitan EB.
        Cardiovascular disease events and mortality after myocardial infarction among Black and White adults: REGARDS study.
        Circ Cardiovasc Qual Outcomes. 2020; 13e006683
        • Mathews R
        • Chen AY
        • Thomas L
        • Wang TY
        • Chin CT
        • Thomas KL
        • Roe MT
        • Peterson ED.
        Differences in short-term versus long-term outcomes of older black versus white patients with myocardial infarction: findings from the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of American College of Cardiology/American Heart Association Guidelines (CRUSADE).
        Circulation. 2014; 130: 659-667
        • Singh JA
        • Lu X
        • Ibrahim S
        • Cram P.
        Trends in and disparities for acute myocardial infarction: an analysis of Medicare claims data from 1992 to 2010.
        BMC Med. 2014; 12: 190
        • Skinner J
        • Chandra A
        • Staiger D
        • Lee J
        • McClellan M.
        Mortality after acute myocardial infarction in hospitals that disproportionately treat black patients.
        Circulation. 2005; 112: 2634-2641
        • Ng DK
        • Brotman DJ
        • Lau B
        • Young JH.
        Insurance status, not race, is associated with mortality after an acute cardiovascular event in Maryland.
        J Gen Intern Med. 2012; 27: 1368-1376
        • Huckfeldt P
        • Escarce J
        • Sood N
        • Yang Z
        • Popescu I
        • Nuckols T.
        Thirty-day postdischarge mortality among black and white patients 65 years and older in the Medicare Hospital Readmissions Reduction Program.
        JAMA Netw Open. 2019; 2e190634
        • Graham GN
        • Jones PG
        • Chan PS
        • Arnold SV
        • Krumholz HM
        • Spertus JA.
        Racial disparities in patient characteristics and survival after acute myocardial infarction.
        JAMA Netw Open. 2018; 1e184240
        • Alkhouli M
        • Holmes Jr, DR
        • Carroll JD
        • Li Z
        • Inohara T
        • Kosinski AS
        • Szerlip M
        • Thourani VH
        • Mack MJ
        • Vemulapalli S.
        Racial disparities in the utilization and outcomes of TAVR: TVT registry report.
        JACC Cardiovasc Intv. 2019; 12: 936-948