Greater stroke rate during hospitalization for acute heart disease among Mexican Americans than non-Hispanic whites

Background and Purpose: This study compared the risk for stroke during acut e myocardial infarction (AMI), percutaneous transluminal coronary angioplas ty (PTCA) and coronary artery bypass grafting (CABG) between Mexican Americ ans (MAs) and non-Hispanic whites. Methods: We examined the age-specific ra te ratios (RR) of acute stroke during hospitalization for AMI, CABG and PTC A in a population-based study in Corpus Christi, Tex, by searching the card iac surveillance data for ICD-9 codes for stroke (430-437). ICD-9 stroke co des were validated by comparing medical chart abstraction with ICD-9 discha rge diagnoses. Results: Stroke codes were found in 220 of the 5,697 admissi ons for AMI, CABG and PTCA. In the 45- to 59-year age-group MAs had a RR of 2.66 (95% CI 1.36-5.23) relative to non-Hispanic whites. In the 60- to 74- year age-group the RR was 1.52 (95% CI 1.11-2.08). There were no significan t differences in the 25- to 44-year age-group. These ethnic relationships w ere found in nondiabetics but not in diabetics. Women in the 45- to 59-year age-group had a RR of 1.88 (95% CI 1.09-3.25) compared with men, but there were no significant sex differences in the 25- to 44- or 59- to 74-year ag e-groups. Stroke ICD-9 codes have a poor positive predictive value for acut e stroke ranging from 10 to 76%. The stroke misclassifications were nondiff erential with respect to ethnicity or sex. Conclusions: MAs have a higher s troke rate complicating acute heart disease in Corpus Christi. A rigorous s troke surveillance project is needed to study the burden of stroke in MAs, the United States' largest Hispanic population.