CAUSES OF CHEST PAIN AND SYMPTOMS SUGGESTIVE OF ACUTE CARDIAC ISCHEMIA IN AFRICAN-AMERICAN PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT - A MULTICENTER STUDY

This study examines whether race is a significant determinant of the d iagnoses of acute myocardial infarction or angina pectoris in patients with symptoms suggestive of acute cardiac ischemia. The study populat ion was comprised of 3401 (34%) African-American and 6600 (66%) white patients who presented to emergency departments with symptoms suggesti ve of acute cardiac ischemia. The main outcome measure was a diagnosis of acute myocardial infarction or angina pectoris. African Americans were younger, predominantly female, and more often had hypertension, d iabetes mellitus, or smoked. The diagnosis of acute myocardial infarct ion was confirmed in 6% of African-American and 12% of white men, and in 4% of African-American and 8% of white women. After adjusting for a ge, gender, medical history, signs and symptoms, and hospital, African Americans were half as likely to develop acute myocardial infarction and were 60% as likely to have acute cardiac ischemia. Despite having less acute cardiac ischemia, African Americans in this study had high risk levels for coronary artery disease.