Introduction: Cardiovascular disease (CVD) is the leading cause of death worldwide. However, the lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) population experiences significant disparities in CVD risk factors, placing them at higher risk for developing CVD. Assessing and addressing risk factors (RF) in this population requires identifying and addressing modifiable barriers in a timely fashion. We aimed to evaluate trainee assessment of CVD RF in the LGBTQ community while identifying potential barriers as opportunities for intervention. Methods: This was a multi-institutional study performed at three academic training programs in Georgia. An anonymous questionnaire was used to assess trainees' (interns, residents, and medical students) identification and perception of CVD RF in the LGBTQ community. The data was compiled and analyzed to identify perceived barriers to LGBTQ CVD RF assessment by medical trainees. Results: A total of 168 surveys were returned. More than a third (37%; 62/168) of trainees noted that the LGBTQ community is at increased risk of developing CVD compared to their cisgender heterosexual peers. Only 3.6% (6/168) reported complete confidence in assessing CVD risk factors in the LGBTQ community. The most identified (90%; 152/168) RF was environmental stress such as discrimination, rejection, and violence followed by HIV/AIDs (83%; 139/168) and hormone replacement therapies (81%; 136/168). Almost half (48%; 77/161) of trainees noted that they address risk factors for CVD in the LGBTQ community less than 25% of the time, listing a lack of knowledge of the unique risk factors in the LGBTQ community 45% (69/152) as the most significant barrier. Conclusion: Identifying and addressing unique CVD RF in LGBTQ populations is pivotal to improving overall CVD outcomes. Medical teaching teams and training programs can play a leading role in educating trainees about these unique risk factors and helping to address knowledge barriers. Our study demonstrates that medical trainees are largely unaware that the LGBTQ community is at increased risk for CVD, presenting a significant opportunity to address cardiovascular health disparities in this community through intentional changes in the structure of medical education.

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Background: Some small powered studies have suggested a paradoxical finding of less severe coronary artery obstruction in African American (AA) males as compared to Caucasian male patients despite a higher prevalence of CVD mortality in AAs. We performed a retrospective study to further identify the difference in the extent of coronary artery obstruction and the prevalence of multivessel disease between an urban hospital and a suburban hospital. Methods: A chart review of cardiac catheterization reports was performed on 3,579 patients from 2 different hospitals (1 urban and 1 suburban center). Statistical analysis was done using R and Stata. Results: Analyzing the main characteristics of the patient population we found that the suburban patient population (SPP) was 7 years older than the urban patient population (UPP) (P-valve= <0.001), 78.4% of the suburban population were Caucasian while 79.7% of the urban center patient population were African Americans (P value= <0.001). 96% of the patient population at the suburban center were insured while 85% of patients at the urban center were insured (P= <0.001). Comorbidity burden was overall higher in the SPP ( P-Value= < 0.001). SPPs were found to have a higher prevalence of severe CAD than UPP (Table 1). However, no significant difference was noted when comparing the prevalence of multivessel disease (Table 2). Conclusion: SPPs are more likely to have severe CAD than UPPs but with a similar level of CAD distribution.