Effects of race, with or without gender, on operative mortality after coronary artery bypass grafting: a study using The Society of Thoracic Surgeons national database

Hartz, Renée S.; Rao, A. V. Ramana; Plomondon, Mary E.; Grover, Frederick L.; Shroyer, A. Laurie

doi:10.1016/s0003-4975(00)02030-0

Cited by 58 publications

(37 citation statements)

References 21 publications

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“…In particular, the difference was most pronounced among lower-risk patients. Hartz et al, 5 using the same STS database, corroborated these results and confirmed that race and sex independently predict adverse outcomes after bypass surgery.…”

Section: Discussionmentioning

confidence: 62%

“…The current study validates previous reports that there remains a disparity in the presentation of and consequently the outcomes of black patients undergoing CABG. [2][3][4][5][6][7][8] The first such comparative studies to document these differences in modern times were conducted in the latter decades of the 20th century. 20 -23 Oberman et al 20 studied the natural history of coronary artery disease in blacks and compared outcomes between blacks and whites after coronary arteriography and CABG.…”

Section: Discussionmentioning

confidence: 99%

“…These findings have been substantiated and highlighted in several publications before and subsequent to the Institute of Medicine report. [2][3][4][5][6][7][8] Two studies from large database registries have confirmed that race is an independent risk factor for adverse events and mortality after coronary artery bypass grafting (CABG). 3,4 As a means of reducing the morbidity and mortality associated with the use of cardiopulmonary bypass (CPB) required for performance of conventional CABG, beating heart, or off-pump coronary artery bypass (OPCAB) was introduced in the United States in the mid-1990s.…”

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confidence: 99%

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Racial Disparity Persists After On-Pump and Off-Pump Coronary Artery Bypass Grafting

et al. 2009

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Racial Disparity Persists After On-Pump and Off-Pump Coronary Artery Bypass Grafting

et al. 2009

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“…However, several studies have highlighted lower CABG utilization rates and worse post‐CABG mortality among women and racial/ethnic minorities, particularly blacks 3, 4, 5, 6, 7. This awareness has spurred multifaceted local and national interventions aimed at narrowing sex‐ and race‐related differences in CABG use and outcomes 8, 9, 10, 11.…”

Section: Introductionmentioning

confidence: 99%

Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014

Angraal

Khera

Wang

et al. 2018

JAHA

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BackgroundWith over a decade of directed efforts to reduce sex and racial differences in coronary artery bypass grafting (CABG) utilization, and post‐CABG outcomes, we sought to evaluate how the use of CABG and its outcomes have evolved in different sex and racial subgroups.Methods and ResultsUsing data on all fee‐for‐service Medicare beneficiaries undergoing CABG in the United States from 1999 to 2014, we examined differences by sex and race in calendar‐year trends for CABG utilization and post‐CABG outcomes (in‐hospital, 30‐day, and 1‐year mortality and 30‐day readmission). A total of 1 863 719 Medicare fee‐for‐service beneficiaries (33.6% women, 4.6% black) underwent CABG from 1999 to 2014, with a decrease from 611 to 245 CABG procedures per 100 000 person‐years. Men compared with women and whites compared with blacks had higher CABG utilization, with declines in all subgroups. Higher post‐CABG annual declines in mortality (95% confidence interval) were observed in women (in‐hospital, −2.70% [−2.97, −2.44]; 30‐day, −2.29% [−2.54, −2.04]; and 1‐year mortality, −1.67% [−1.88, −1.46]) and blacks (in‐hospital, −3.31% [−4.02, −2.60]; 30‐day, −2.80% [−3.49, −2.12]; and 1‐year mortality, −2.38% [−2.92, −1.84]), compared with men and whites, respectively. Mortality rates remained higher in women and blacks, but differences narrowed over time. Annual adjusted 30‐day readmission rates remained unchanged for all patient groups.ConclusionsWomen and black patients had persistently higher CABG mortality than men and white patients, respectively, despite greater declines over the time period. These findings indicate progress, but also the need for further progress.

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“…In clinical practice, a correlation of racial affiliation, as assessed from skin color, facial characteristics, hair texture, and so forth, with disease pathology and drug response is widely believed to exist. A PubMed search with the keywords "human races" (January 10, 2002) yielded 34,143 papers, including Benar et al (2001), Estrada and Billett (2001), Hartz et al (2001), Hoffman et al (2001), and Shaw and Krause (2001).…”

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confidence: 99%

Patterns of Human Diversity, within and among Continents, Inferred from Biallelic DNA Polymorphisms

Romualdi¹,

Balding²,

Nasidze³

et al. 2002

Genome Res.

200

123

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Previous studies have reported that about 85% of human diversity at Short Tandem Repeat (STR) and Restriction Fragment Length Polymorphism (RFLP) autosomal loci is due to differences between individuals of the same population, whereas differences among continental groups account for only 10% of the overall genetic variance. These findings conflict with popular notions of distinct and relatively homogeneous human races, and may also call into question the apparent usefulness of ethnic classification in, for example, medical diagnostics. Here, we present new data on 21 Alu insertions in 32 populations. We analyze these data along with three other large, globally dispersed data sets consisting of apparently neutral biallelic nuclear markers, as well as with a ␤-globin data set possibly subject to selection. We confirm the previous results for the autosomal data, and find a higher diversity among continents for Y-chromosome loci. We also extend the analyses to address two questions: (1) whether differences between continental groups, although small, are nevertheless large enough to confidently assign individuals to their continent on the basis of their genotypes; (2) whether the observed genotypes naturally cluster into continental or population groups when the sample source location is ignored. Using a range of statistical methods, we show that classification errors are at best around 30% for autosomal biallelic polymorphisms and 27% for the Y chromosome. Two data sets suggest the existence of three and four major groups of genotypes worldwide, respectively, and the two groupings are inconsistent. These results suggest that, at random biallelic loci, there is little evidence, if any, of a clear subdivision of humans into biologically defined groups.In various areas of applied genetics, it is customary to regard the human species as divided in distinct and objectively recognizable groups. Forensic scientists compare DNA profiles from the place of a crime with databases from the general population, usually grouped into broad racial categories (for instance, African-American, European-American, Asian, and Hispanic), to estimate the probability that an unrelated individual would have the identical DNA profile. The markers chosen for DNA profiling are considered to be essentially uniform across populations of the same category. Although the existence of problems with group definition has been acknowledged (e.g., Weir 2001), the fact that some individuals may not be easy to allocate to any such group is usually regarded as unimportant (National Research Council 1992;Lander and Budowle 1994;Morton 1994;Roeder 1994;Gill and Evett 1995). In clinical practice, a correlation of racial affiliation, as assessed from skin color, facial characteristics, hair texture, and so forth, with disease pathology and drug response is widely believed to exist. A PubMed search with the keywords "human races" (January 10, 2002) In contrast, population studies have suggested that genetic variation is essentially continuous through space amon...

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Effects of race, with or without gender, on operative mortality after coronary artery bypass grafting: a study using The Society of Thoracic Surgeons national database

Cited by 58 publications

References 21 publications

Racial Disparity Persists After On-Pump and Off-Pump Coronary Artery Bypass Grafting

Racial Disparity Persists After On-Pump and Off-Pump Coronary Artery Bypass Grafting

Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014

Patterns of Human Diversity, within and among Continents, Inferred from Biallelic DNA Polymorphisms

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