Recovery from Heart Attack Worse for Blacks

NEW YORK (Reuters Health) - One year after suffering a heart attack or other acute cardiac event, blacks living in the U.S. have more chest pain and physical limitations and worse quality of life compared with their white counterparts, research indicates.

These disparities in outcome are not explained by differences in the immediate treatment and care received or in the severity of the event.

"This new study suggests that current post-acute coronary syndrome health care is failing in blacks," Dr. John S. Rumsfeld from the Denver VA Medical Center in Colorado, who was not connected with the study, said in a statement.

It has been known for a long time that black patients are treated differently than white patients after a heart attack. They are less likely to undergo angioplasty or have stents placed. Despite this, however, most prior studies have suggested similar survival among blacks and whites, but none of these studies explored the impact of care on recovery after a heart attack.

"One of the principal goals of treating patients with an acute coronary syndrome is to minimize the impact of the underlying coronary disease on their lives -- their symptoms, function and quality of life," Dr. John Spertus, who led the research, told Reuters Health. "We found that black patients have worse recovery in these domains than white patients," he said.

In the study, Spertus, from the Mid Atlantic Heart Institute of Saint Luke's Hospital in Kansas City, Missouri, and colleagues tracked 196 black and 963 white adults treated at two Kansas City hospitals for an acute coronary syndrome. After one year, 81 patients had died and 199 were lost to follow up, according to the team's report in the Journal of the American College of Cardiology.

Although death rates were nearly identical between black and white subjects - roughly 7 percent for each group - blacks were more than twice as likely as whites to have chest pain (43 percent versus 27 percent) at one year. Blacks also had a worse quality of life and poorer physical function, according to responses to standard questionnaires.

"Importantly," Spertus told Reuters Health, "only part of this was explained by differences in the use of invasive treatments. We speculate that there are other aspects of care -- outpatient care, use of medicines, etc. -- that need further exploration to see how best to eradicate disparities in care," he added.

According to Rumsfeld, most patients -- both black and white -- survive an acute cardiac event, but until now no study has documented racial differences in the quality of life fro those patients.

SOURCE: Journal of the American College of Cardiology, November 15, 2005.