GREATER CASE-FATALITY AFTER MYOCARDIAL-INFARCTION AMONG MEXICAN-AMERICANS AND WOMEN THAN AMONG NON-HISPANIC WHITES AND MEN - THE CORPUS-CHRISTI HEART PROJECT

Age-adjusted 28-day case-fatality rates were higher among Mexican Amer icans than among non-Hispanic whites and higher among women than among men hospitalized for definite or possible myocardial infarction in Co rpus Christi, Nueces County, Texas, from May 1, 1988, through April 30 , 1990. The authors therefore examined whether these higher case-fatal ity rates were associated with greater prevalence of previously diagno sed coronary heart disease or diabetes; with greater age, frequency of definite myocardial infarction, or congestive heart failure; with hig her values of indicators of severity of infarction, including peak cre atine phosphokinase levels and scales prognostic of early mortality af ter myocardial infarction; and with differences in receipt of in-hospi tal therapy. The overall 28-day case-fatality rate among 1,228 patient s hospitalized for myocardial infarction during a 24-month period was 7.3%. After adjustment for age; diabetes; myocardial infarction class (definite vs. possible); congestive heart failure; the Norris and Peel severity indices; peak total creatine phosphokinase; and receipt of t hrombolytic therapy, aspirin, calcium channel blockers, beta-blockers, anticoagulants, angioplasty, and bypass surgery, the risk of 28-day c ase-fatality for Mexican Americans in relation to non-Hispanic whites was 1.49 (95% confidence interval 0.92-2.40). The corresponding risk f or women in relation to men was 1.80 (95% confidence interval 1.12-2.8 9). These findings should alert clinicians to the high-risk status of these groups of patients.