Black, female patients more likely to report angina symptoms after heart attack

February 7, 2017 – A new DCRI study also found that 6-week angina was most strongly associated with unplanned rehospitalization for heart attack patients.

Black and female patients are more likely to report persistent angina symptoms following hospitalization for heart attack, according to a new study by DCRI researchers.

The study appears in the Feb. 7 issue of Circulation. The DCRI’s Tracy Wang, MD, MHS, MSc, served as senior author.

Race and gender disparities in cardiac care have been well-documented, but until now there has been little research into angina symptom frequency and rehospitalization risk following a heart attack. More than 1.5 million Americans experience a heart attack each year, and many of these patients experience angina symptoms afterwards. These symptoms usually include pain or tightness in the chest.

In this study, DCRI researchers and their colleagues analyzed data from the TRANSLATE-ACS study (Treatment with Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events after Acute Coronary Syndrome). TRANSLATE-ACS is one of the largest, prospective, longitudinal studies in the United States, observing the treatment and outcomes of more than 12,000 heart attack patients treated with coronary stenting procedures at 233 hospitals.

For this study, the researchers included data from 11,595 patients from 231 hospitals across the United States. Of these patients, there were 7,726 (66.6 percent) white male patients, 2,816 (24.3 percent) white female patients, 616 (5.3 percent) black male patients, and 437 (3.8 percent) black female patients. Among all patients, 29.7 percent reported angina at 6 weeks, and 20.6 percent had angina at one year after hospital discharge.

Compared to white patients, black patients were more likely to have angina at 6 weeks (female: 44.2 percent versus 31.8 percent; male: 33.5 percent versus 27.1 percent) and 1 year (female: 49.4 percent versus 38.9 percent; male: 46.3 percent versus 31.1 percent). Rates of 1-year unplanned rehospitalization were highest among black female patients (44.1 percent), followed by white female patients (38.4 percent), black male patients (36.4 percent), and white male patients (30.2 percent).

The researchers also found that 6-week angina was most strongly associated with unplanned rehospitalization.

These findings, the researchers concluded, demonstrate that significant race and gender disparities among heart patients still exist. Addressing these disparities is key to improving outcomes among the groups most affected, particularly black women.

In addition to Wang, the study’s author’s included Connie N. Hess, MD, MHS; Lisa A. Kaltenbach, MS; Jacob A. Doll, MD; David J. Cohen, MD; and Eric D. Peterson, MD, MPH.