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Int. J. Environ. Res. Public Health 2015, 12(7), 7478-7490; doi:10.3390/ijerph120707478

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

1
Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA
2
Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
3
Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
4
Center for Minority Health and Health Disparities Research and Education, Xavier University of Louisiana, New Orleans, LA 70125, USA
5
Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
6
Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
7
The College of Nursing, East Carolina University, Greenville, NC 27834, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 28 December 2014 / Revised: 13 February 2015 / Accepted: 13 February 2015 / Published: 6 July 2015
View Full-Text   |   Download PDF [729 KB, uploaded 6 July 2015]   |  

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; Pinteraction < 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. View Full-Text
Keywords: inotropes; cardiac surgery; mortality; disparities; heart disease; heart failure inotropes; cardiac surgery; mortality; disparities; heart disease; heart failure
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Efird, J.T.; Griffin, W.F.; Sarpong, D.F.; Davies, S.W.; Vann, I.; Koutlas, N.T.; Anderson, E.J.; Crane, P.B.; Landrine, H.; Kindell, L.; Iqbal, Z.J.; Ferguson, T.B.; Chitwood, W.R.; Kypson, A.P. Increased Long-Term Mortality among Black CABG Patients Receiving Preoperative Inotropic Agents. Int. J. Environ. Res. Public Health 2015, 12, 7478-7490.

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