What are the racial predilections of unstable angina?

Updated: Oct 01, 2020
  • Author: Walter Tan, MD, MS; Chief Editor: Eric H Yang, MD  more...
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Answer

Disparities in outcome and risk-factor prevalence among different ethnic groups have been widely reported. For instance, as a group, black persons exhibit a higher prevalence of atherosclerotic risk factors (eg, hypertension, diabetes mellitus, and smoking), greater left ventricular mass, and decreased peripheral vasodilatory response. Relative to white persons, MI more frequently results in death in black individuals at young ages.

Fewer myocardial events but more cerebral complications have also been observed in black patients with unstable angina in randomized clinical trials of heparin versus hirudin (the Global Utilization of Streptokinase and TPA [tissue plasminogen activator] for Occluded coronary arteries II [GUSTO II] trial) or eptifibatide versus placebo (the Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy [PURSUIT] trial), possibly because of enhanced fibrinolytic activity and a higher prevalence of hypertension.

Racial differences also exist with regard to the delivery and response to medical care. White individuals have a higher rate of catheterization, angioplasty, and bypass surgery than individuals from other racial groups do.

Studies have shown equivalent short-term (30-day) mortality figures from unstable angina (including NQMI) for black individuals, but over the long term, persistent worse outcomes have been demonstrated.


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