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Hispanics Less Likely to Get Repeat Artery Surgery

Even though they have risk factors that could lead to coronary problems, study finds

SUNDAY, Nov. 9 (HealthDay News) -- Despite certain risk factors, Hispanic patients were 57 percent less likely than Caucasians to undergo coronary artery bypass surgery (CABG) one year after successful angioplasty to open blocked coronary arteries, a new study found.

It also found that Hispanics were less likely to have any kind of repeat revascularization (artery opening) procedures, more likely to have diabetes (increasing their risk for heart attack), and more likely to have long lesions blocking their arteries -- an average length of 15.4 millimeters vs. 14.1 millimeters in whites.

The study included 542 Hispanic and 1,357 white patients who had percutaneous coronary intervention (PCI), such as angioplasty, from 1999 to 2006. The Hispanic patients were, on average, three years younger than the white patients, but were more likely to have: hypertension (80.4 percent vs. 72.3 percent), diabetes (49.2 percent vs. 27.8 percent), and insulin-treated diabetes (15 percent vs. 7.4 percent).

However, Hispanic patients had less peripheral artery disease (5.6 percent vs. 10.3 percent); prior heart attack (25.8 percent vs. 30.9 percent), and prior PCI (27.8 percent vs. 34.1 percent).

Whites and Hispanics had similar rates of heart attack and death one year after PCI, said the study, expected to be presented Sunday at the American Heart Association's Scientific Sessions, in New Orleans.

"It's interesting that Hispanics were younger and had more risk factors," study author Dr. Shailja V. Parikh, a fellow in the department of internal medicine, division of cardiology at the University of Texas Southwestern Medical Center at Dallas, said in an AHA news release.

"With higher rates of insulin-treated diabetes, hypertension and longer lesion lengths, one would expect Hispanic patients to have higher rates of repeat revascularization either through CABG or PCI. However, despite having these risk factors for increased rates of restenosis (artery narrowing), Hispanics were found to be revascularized less often after initial PCI than their Caucasian counterparts," Parikh said.

"It is possible that a referral bias exists in which Hispanic patients are not being referred for coronary artery bypass surgery as commonly as Caucasians. Or, there may be mediating factors intrinsic to the Hispanic patient that could be protective toward restenosis," Parikh added.

More information

The U.S. National Heart, Lung, and Blood Institute has more about coronary artery disease.

-- Robert Preidt

SOURCE: American Heart Association, news release, Nov. 9, 2008

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