The impact of race on the acute management of XXXX .

@entity662 @entity1187 @entity1 @entity301 @entity951 @entity453 @entity583 @entity2723
OBJECTIVES: African Americans with @entity1187 receive cardiac catheterization less frequently than whites. The objective was to determine if such disparities extend to acute evaluation and non interventional treatment. METHODS: Data on adults with @entity662 (N = 7,935) presenting to eight emergency departments (EDs) were evaluated from the Internet Tracking Registry of Acute @entity301 . Groups were selected from final ED diagnosis: 1) @entity583 ( @entity583 ), n = 400; 2) unstable @entity951 /non-ST-elevation @entity583 (UA/NSTEMI), n = 1,153; and 3) nonacute coronary syndrome @entity662 (non-ACS @entity2723 ), n = 6,382. American College of Cardiology/American Heart Association guidelines for @entity583 and UA/NSTEMI were used to evaluate racial disparities with logistic regression models. Odds ratios (ORs) were adjusted for age, gender, guideline publication, and insurance status. Non-ACS @entity2723 @entity1 were assessed by comparing electrocardiographic (ECG)/laboratory evaluation, medical treatment, admission rates, and invasive and noninvasive testing for @entity453 ( @entity453 ). RESULTS: African Americans with UA/NSTEMI received glycoprotein IIb/IIIa receptor inhibitors less often than whites (OR, 0.41; 95% CI = 0.19 to 0.91). African Americans with non-ACS @entity2723 underwent ECG/laboratory evaluation, medical treatment, and invasive and noninvasive testing for @entity453 less often than whites (p < 0.05). Other nonwhites with non-ACS @entity2723 were admitted and received invasive testing for @entity453 less often than whites (p < 0.01). African Americans and other nonwhites with @entity583 underwent catheterization less frequently than whites (OR, 0.45; 95% CI = 0.29 to 0.71 and OR, 0.40; 95% CI = 0.17 to 0.92, respectively). A similar disparity in catheterization was noted in UA/NSTEMI therapy (OR, 0.53; 95% CI = 0.40 to 0.68 and OR, 0.68; 95% CI = 0.47 to 0.99). CONCLUSIONS: Racial disparities in acute @entity662 management extend beyond cardiac catheterization. Poor compliance with recommended treatments for ACS may be an explanation.
