RCMI International Symposium on Health Disparities
November 12-15, 2000
San Juan, Puerto Rico
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Oral Presentations

USE OF CORONARY REVASCULARIZATION PROCEDURES AFTER ACUTE CORONARY SYNDROMES IN ASIAN AMERICANS AND PACIFIC ISLANDERS.

DA Taira, ScD, C Marciel, P Yamashita, TB Seto, MD, MPH. From the Hawaii Medical Service Association (DAT, CM, PY) and John A. Burns School of Medicine, University of Hawaii (DAT, TBS).

The purpose of this study was to examine revascularization rates following acute coronary syndromes among Asian/Pacific Islander Americans and Caucasians, using administrative data. Of the 5514 enrollees in Hawaii's largest health plan who had an acute coronary syndrome (acute myocardial infarction or unstable angina) from 1997 to 1999, ethnicity information was known for 47% (n=2606). Logistic regression models were used to compare treatment and mortality during the initial hospitalization.

Treatment and mortality for acute coronary syndrome by ethnicity

PTCA

CABG

In-hospital mortality
 

OR*

p-value

OR

p-value

OR

p-value

Japanese (n=1117)

0.76

0.019

1.45

0.003

1.50

0.266

Filipino (n=284)

0.58

0.001

1.21

0.250

1.70

0.353

Hawaiian (n=313)

0.52

<0.001

1.32

0.095

2.24

0.071

Chinese (n=215)

0.82

0.257

1.67

0.005

1.58

0.353

* Odds ratio relative to Caucasians (n=523) adjusted for age, sex, diabetes mellitus, congestive heart failure, health care delivery system, Ambulatory Care Group (ACG).
PTCA= percutaneous transluminal coronary angioplasty CABG= coronary artery bypass graft

The likelihood of undergoing any revascularization (PTCA or CABG) was significantly lower for Hawaiians (OR:0.71, p=0.026) and Filipinos (OR:0.68, p=0.013) than for Caucasians, but was similar between Caucasians and Japanese and Chinese patients. Compared to Caucasians, in-hospital mortality was higher for all Asian American and Pacific Islander group than for Caucasians but these differences were not statistically significant at alpha = 0.05. Further study is needed to determine how these utilization disparities and other factors affect racial and ethnic differences in long-term health outcomes, including morbidity, mortality and health-related quality of life.