Racial differences in the use of cardiac catheterization after acute myocardial infarction.

Background: Several studies have reported that black patients are less like ly than white patients to undergo cardiac catheterization after acute myoca rdial infarction. The role of the race of the physician in this pattern is unknown. Methods: We analyzed data from the Cooperative Cardiovascular Project, a st udy of Medicare beneficiaries hospitalized for acute myocardial infarction in 1994 and 1995, to evaluate whether differences between black patients an d white patients in the use of cardiac catheterization within 60 days after acute myocardial infarction varied according to the race of their attendin g physician. Results: Our study cohort consisted of 35,676 white and 4039 black patients with acute myocardial infarction who were treated by 17,550 white and 588 black physicians. Black patients had lower rates of cardiac catheterization than white patients, regardless of whether their attending physician was w hite (rate of catheterization, 38.4 percent vs. 45.7 percent; P<0.001) or b lack (38.2 percent vs. 49.6 percent, P<0.001). We did not find a significan t interaction between the race of the patients and the race of the physicia ns in the use of cardiac catheterization. The adjusted mortality rate among black patients was lower than or similar to that among white patients for up to three years after the infarction. Conclusions: Racial differences in the use of cardiac catheterization are s imilar among patients treated by white physicians and those treated by blac k physicians, suggesting that this pattern of care is independent of the ra ce of the physician. (N Engl J Med 2001;344:1443-9.) Copyright (C) 2001 Mas sachusetts Medical Society.