Clinical and angiographic findings in black patients with suspected coronary artery disease

https://doi.org/10.1016/S0167-5273(97)00253-2Get rights and content

Abstract

To determine the clinical variables and coronary angiographic findings in black patients with suspected coronary artery disease, we analyzed the data on consecutive black patients undergoing their first coronary angiogram over a three year period at the Cook County Hospital, Chicago, Illinois. We compared these findings to those of black and white patients from previous studies. There were 654 patients with a mean age±standard deviation of 56±10 years; 309 (47%) were men. Two hundred nineteen patients (33%) presented with unstable angina, 75 patients (12%) with acute myocardial infarction and 338 patients (52%) with chronic stable angina. Three hundred forty-six patients (53%) had 50% or greater stenosis in at least one of the major vessels. Among the patients with coronary artery disease, 128 patients (37%) had one vessel disease, 102 patients (29%) had two-vessel disease, and 116 patients (34%) had three-vessel disease. Black patients who undergo coronary angiography for suspected coronary artery disease have a high frequency of normal coronary angiogram or non-obstructive coronary artery disease. The frequency of 1-, 2- and 3-vessel disease in blacks with coronary artery disease is comparable to those observed in whites in previous reports.

Section snippets

Background

It is now recognized that mortality rates from ischemic heart disease are similar in blacks and whites and that the rate in blacks may exceed that in whites for the age group 25 to 64 years. More importantly, the proportion of sudden cardiac death may be greater in blacks and in whites. Besides possible racial differences in the pathogenesis and susceptibility to diseases, the epidemiologic features of coronary artery disease are influenced by socioeconomic and cultural factors 1, 2. There is,

Setting and patients

The study was conducted at the Cook County Hospital which is a 1000 bed public hospital serving predominantly the urban population of Chicago, Illinois. Clinical and angiographic data were collected from medical records and from the reports of cardiac catheterization. Records of all patients who underwent cardiac catheterization primarily for suspected coronary artery disease from January 1992 through December 1994 were reviewed. Patients of other races and black patients who had previous

Clinical findings

There were 654 patients; 309 patients (47%) were men and 345 patients (53%) were women. Their ages ranged from 27 to 82 years with a mean±standard deviation of 56±10 years. Hypertension was present in 528 patients (81%) and diabetes mellitus in 158 patients (24%). Twenty-three patients (4%) had history of stroke, and 91 patients (14%) had history of congestive heart failure. One hundred and fifty patients (23%) had history of prior myocardial infarction. Three hundred sixty-nine patients (56%)

Angiographic findings in blacks vs. whites

In the Coronary Artery Surgery Study, the frequency of 1-, 2- and 3-vessel disease in black patients (men and women together) with obstructive coronary artery disease was 34%, 30% and 36% respectively; in white patients with obstructive coronary artery disease, in the same study, these were 32%, 32% and 36% respectively [4]. The frequency of 1-, 2- and 3-vessel coronary artery disease in patients in the present study was 37%, 29% and 34% respectively. Our results in this regard were comparable

Conclusion

Black patients who undergo coronary angiography for suspected coronary artery disease have a high frequency of normal coronary angiogram or non-obstructive coronary artery disease. However, the frequency of 1-, 2- and 3-vessel disease in black patients with coronary artery disease is comparable to those observed in white patients in previous reports. The pathogenesis of ischemic heart disease and high cardiac mortality in blacks need further investigation.

Acknowledgements

The authors wish to thank Ruby Stubbs & Vashti Murray for expert secretarial assistance; Barbara Bradford, George Samuel, Manijeh Rezaian and the staff in the Cardiac Catheterization Laboratory for assistance in data collection and Shyam Nair, M.D. for assistance in literature review.

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