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

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; T Bruce Ferguson; W Randolph Chitwood; Alan P Kypson

doi:10.3390/ijerph120707478

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

Journal article

Open access

Peer reviewed

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

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, …

International journal of environmental research and public health, Vol.12(7), pp.7478-7490

07/06/2015

DOI: 10.3390/ijerph120707478

PMCID: PMC4515669

PMID: 26154656

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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.

Humans

Middle Aged

Risk Factors

Kaplan-Meier Estimate

African Americans

European Continental Ancestry Group

Male

Coronary Artery Disease - ethnology

Incidence

Cardiotonic Agents - therapeutic use

Coronary Artery Bypass - mortality

Postoperative Care

Female

Aged

Retrospective Studies

Continental Population Groups

Details

Title: Subtitle: Increased Long-Term Mortality among Black CABG Patients Receiving Preoperative Inotropic Agents
Creators: Jimmy T Efird - Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA. jimmy.efird@stanfordalumni.org
William F Griffin - Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. griffinw11@students.ecu.edu
Daniel F Sarpong - Center for Minority Health and Health Disparities Research and Education, Xavier University of Louisiana, New Orleans, LA 70125, USA. dsarpong@xula.edu
Stephen W Davies - Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA. SD2WF@hscmail.mcc.virginia.edu
Iulia Vann - Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA. vanni13@students.ecu.edu
Nathaniel T Koutlas - Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. koutlasnate@gmail.com
Ethan J Anderson - Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA. andersonet@ecu.edu
Patricia B Crane - The College of Nursing, East Carolina University, Greenville, NC 27834, USA. cranep14@ecu.edu
Hope Landrine - Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA. landrineh@ecu.edu
Linda Kindell - Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. kindelll@ecu.edu
Zahra J Iqbal - Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. iqbalz@ecu.edu
T Bruce Ferguson - Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. fergusont@ecu.edu
W Randolph Chitwood - Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. chitwoodw@ecu.edu
Alan P Kypson - Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. kypsona@ecu.edu
Resource Type: Journal article
Publication Details: International journal of environmental research and public health, Vol.12(7), pp.7478-7490
DOI: 10.3390/ijerph120707478
PMID: 26154656
PMCID: PMC4515669
NLM abbreviation: Int J Environ Res Public Health
ISSN: 1661-7827
eISSN: 1660-4601
Publisher: Switzerland
Grant note: P20 MD006899 / NIMHD NIH HHS R01 HL122863 / NHLBI NIH HHS G12 MD007595 / NIMHD NIH HHS R01-HL122863 / NHLBI NIH HHS
Language: English
Date published: 07/06/2015
Academic Unit: Pharmaceutical Sciences and Experimental Therapeutics; Fraternal Order of Eagles Diabetes Research Center; Health, Sport, and Human Physiology
Record Identifier: 9984065693702771

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