{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T05:42:04Z","timestamp":1773207724263,"version":"3.50.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2014,8,19]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Blacks are less likely than whites to receive coronary revascularization and evidence-based therapies after acute myocardial infarction, yet the impact of these differences on long-term outcomes is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We linked Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of American College of Cardiology\/American Heart Association Guidelines (CRUSADE) registry data to national Medicare claims, creating a longitudinal record of care and outcomes among 40 500 patients with non\u2013ST-segment\u2013elevation myocardial infarction treated at 446 hospitals to examine mortality and readmission rates (mean follow-up, 2.4 years) among black and white patients. Relative to whites (n=37 384), blacks (n=3116) were more often younger and female; more often had diabetes mellitus and renal failure; and received less aggressive interventions, including cardiac catheterization (60.7% versus 54.0%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), percutaneous coronary intervention (32.1% versus 23.8%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and coronary bypass surgery (9.2% versus 5.7%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Although blacks had lower 30-day mortality (9.1% versus 9.9%; adjusted hazard ratio, 0.80; 95% confidence interval, 0.71\u20130.92), they had higher observed mortality at 1 year (27.9% versus 24.5%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), although this was not significant after adjustment on long-term follow-up (hazard ratio, 1.00; 95% confidence interval, 0.94\u20131.07). Black patients also had higher 30-day (23.6% versus 20.0%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and 1-year (62.0% versus 54.6%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) all-cause readmission, but these differences were no longer significant after risk adjustment on 30-day (hazard ratio, 1.02; 95% confidence interval, 0.92\u20131.13) and long-term (hazard ratio, 1.05; 95% confidence interval, 1.00\u20131.11) follow-up.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Although older blacks with an acute myocardial infarction had lower initial mortality rates than whites, this early survival advantage did not persist during long-term follow-up. The reasons for this are multifactorial but may include differences in comorbidities and postdischarge care.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.113.008370","type":"journal-article","created":{"date-parts":[[2014,7,8]],"date-time":"2014-07-08T02:35:00Z","timestamp":1404786900000},"page":"659-667","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Differences in Short-Term Versus Long-Term Outcomes of Older Black Versus White Patients With Myocardial Infarction"],"prefix":"10.1161","volume":"130","author":[{"given":"Robin","family":"Mathews","sequence":"first","affiliation":[{"name":"From the Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.M., A.Y.C., L.T., T.Y.W., K.L.T., M.T.R., E.D.P.); and National Heart Centre Singapore, Singapore (C.T.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.M., A.Y.C., L.T., T.Y.W., K.L.T., M.T.R., E.D.P.); and National Heart Centre Singapore, Singapore (C.T.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laine","family":"Thomas","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.M., A.Y.C., L.T., T.Y.W., K.L.T., M.T.R., E.D.P.); and National Heart Centre Singapore, Singapore (C.T.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.M., A.Y.C., L.T., T.Y.W., K.L.T., M.T.R., E.D.P.); and National Heart Centre Singapore, Singapore (C.T.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chee Tang","family":"Chin","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.M., A.Y.C., L.T., T.Y.W., K.L.T., M.T.R., E.D.P.); and National Heart Centre Singapore, Singapore (C.T.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin L.","family":"Thomas","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.M., A.Y.C., L.T., T.Y.W., K.L.T., M.T.R., E.D.P.); and National Heart Centre Singapore, Singapore (C.T.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew T.","family":"Roe","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.M., A.Y.C., L.T., T.Y.W., K.L.T., M.T.R., E.D.P.); and National Heart Centre Singapore, Singapore (C.T.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric D.","family":"Peterson","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.M., A.Y.C., L.T., T.Y.W., K.L.T., M.T.R., E.D.P.); and National Heart Centre Singapore, Singapore (C.T.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510390045028"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.13.1563"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199308263290907"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(00)90017-6"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000157732.03358.64"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.05.084"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199702133360706"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200105103441906"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1197\/aemj.9.11.1146"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.04.002"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1176350951"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1991.10475101"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2008.00837.x"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2006.00688.x"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.19.2517"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2011.08.010"},{"key":"e_1_3_4_18_2","unstructured":"US Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions Evaluation and Analysis Branch. 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