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Increased Long-Term Mortality among Black CABG Patients Receiving Preoperative Inotropic Agents

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  • Jimmy T. Efird

    (Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA
    Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
    Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA)

  • William F. Griffin

    (Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA)

  • Daniel F. Sarpong

    (Center for Minority Health and Health Disparities Research and Education, Xavier University of Louisiana, New Orleans, LA 70125, USA)

  • Stephen W. Davies

    (Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA)

  • Iulia Vann

    (Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA)

  • Nathaniel T. Koutlas

    (Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA)

  • Ethan J. Anderson

    (Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA)

  • Patricia B. Crane

    (The College of Nursing, East Carolina University, Greenville, NC 27834, USA)

  • Hope Landrine

    (Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA)

  • Linda Kindell

    (Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA)

  • Zahra J. Iqbal

    (Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA)

  • T. Bruce Ferguson

    (Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA)

  • W. Randolph Chitwood

    (Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA)

  • Alan P. Kypson

    (Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA)

Abstract

The aim of this study was to examine racial differences in long-term mortality after coronary artery bypass grafting (CABG), stratified by preoperative use of inotropic agents. Black and white patients who required preoperative inotropic support prior to undergoing CABG procedures between 1992 and 2011 were compared. Mortality probabilities were computed using the Kaplan-Meier product-limit method. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model. A total of 15,765 patients underwent CABG, of whom 211 received preoperative inotropic agents within 48 hours of surgery. Long-term mortality differed by race (black versus white) among preoperative inotropic category (inotropes: adjusted HR = 1.6, 95% CI = 1.009–2.4; no inotropes: adjusted HR = 1.15, 95% CI = 1.08–1.2; P interaction < 0.0001). Our study identified an independent preoperative risk-factor for long-term mortality among blacks receiving CABG. This outcome provides information that may be useful for surgeons, primary care providers, and their patients.

Suggested Citation

  • Jimmy T. Efird & William F. Griffin & Daniel F. Sarpong & Stephen W. Davies & Iulia Vann & Nathaniel T. Koutlas & Ethan J. Anderson & Patricia B. Crane & Hope Landrine & Linda Kindell & Zahra J. Iqbal, 2015. "Increased Long-Term Mortality among Black CABG Patients Receiving Preoperative Inotropic Agents," IJERPH, MDPI, vol. 12(7), pages 1-13, July.
    • Handle: RePEc:gam:jijerp:v:12:y:2015:i:7:p:7478-7490:d:52109
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    References listed on IDEAS

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    1. Jimmy T. Efird & Wesley T. O'Neal & Paul Bolin & Stephen W. Davies & Jason B. O'Neal & Curtis A. Anderson & T. Bruce Ferguson & W. Randolph Chitwood & Alan P. Kypson, 2013. "Racial Differences in Survival among Hemodialysis Patients after Coronary Artery Bypass Grafting," IJERPH, MDPI, vol. 10(9), pages 1-11, September.
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    1. Jimmy T. Efird & Wesley T. O'Neal & Stephen W. Davies & Jason B. O'Neal & Linda C. Kindell & Curtis A. Anderson & W. Randolph Chitwood & T. Bruce Ferguson & Alan P. Kypson, 2014. "Risk-Adjusted Survival after Coronary Artery Bypass Grafting: Implications for Quality Improvement," IJERPH, MDPI, vol. 11(7), pages 1-12, July.

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