SEX AND ETHNIC-DIFFERENCES IN USE OF MYOCARDIAL REVASCULARIZATION PROCEDURES IN MEXICAN-AMERICANS AND NON-HISPANIC WHITES - THE CORPUS-CHRISTI HEART PROJECT

Age-adjusted rates of percutaneous transluminal coronary angioplasty ( PTCA) and aortocoronary bypass surgery (ACBS) were determined for Mexi can American (MA) and non-Hispanic white (NHW) patients hospitalized f or coronary heart disease. Hypotheses of equal receipt of procedures b etween gender and ethnic groups were tested. Following myocardial infa rction (MI), women were less likely than men to receive either procedu re (22 versus 32%, p < 0.01), and MA were less likely than NHW to rece ive PTCA (13 versus 23%, p < 0.01) but not ACBS. After adjustment for extent of disease and other potential confounders, ethnic groups diffe red marginally in receipt of PTCA but not ACBS, while gender differenc es were not significant. Although women received revascularization pro cedures less frequently than men, this difference did not persist afte r controlling for extent of coronary artery disease by angiography; th erefore, these observed differences in delivery of health care service s may be appropriate. Mexican Americans received PTCA, but not ACBS, l ess frequently than NHW. This selective ethnic difference in receipt o f PTCA does not appear to be associated with the extent of disease or other medical characteristics, and may represent inappropriate bias in delivery of health care services. (C) 1997 Elsevier Science Inc.