title: Greater stroke rate during hospitalization for acute heart disease among Mexican Americans than non-Hispanic whites.
abstract: OBJECTIVE
  This study compared the risk for stroke during acute myocardial infarction (AMI), percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) between Mexican Americans (MAs) and non-Hispanic whites.
  
  
  METHODS
  We examined the age-specific rate ratios (RR) of acute stroke during hospitalization for AMI, CABG and PTCA in a population-based study in Corpus Christi, Tex. by searching the cardiac surveillance data for ICD-9 codes for stroke (430-437). ICD-9 stroke codes were validated by comparing medical chart abstraction with ICD-9 discharge diagnoses.
  
  
  RESULTS
  Stroke codes were found in 220 of the 5,697 admissions for AMI, CABG and PTCA. In the 45- to 59-year age-group MAs had a RR of 2.66 (95% CI 1.36-5.23) relative to non-Hispanic whites. In the 60- to 74-year age-group the RR was 1.52 (95% CI 1.11-2.08). There were no significant differences in the 25- to 44-year age-group. These ethnic relationships were found in nondiabetics but not in diabetics. Women in the 45- to 59-year age-group had a RR of 1.88 (95% CI 1.09-3.25) compared with men, but there were no significant sex differences in the 25- to 44- or 59- to 74-year age-groups. Stroke ICD-9 codes have a poor positive predictive value for acute stroke ranging from 10 to 76%. The stroke misclassifications were nondifferential with respect to ethnicity or sex.
  
  
  CONCLUSIONS
  MAs have a higher stroke rate complicating acute heart disease in Corpus Christi. A rigorous stroke surveillance project is needed to study the burden of stroke in MAs, the United States' largest Hispanic population.
authors.affiliation: Department of Neurology, The University of Texas Medical School at Houston, Houston, TX 77030, USA. 1morgens@neuro.med.uth.tmc.edu
authors.forename: L B
authors.initials: LB
authors.lastname: Morgenstern
authors.forename: D K
authors.initials: DK
authors.lastname: Pandey
authors.forename: M A
authors.initials: MA
authors.lastname: Smith
authors.forename: D
authors.initials: D
authors.lastname: Ramsey
authors.forename: D R
authors.initials: DR
authors.lastname: Labarthe
authors.forename: M Z
authors.initials: MZ
authors.lastname: Nichaman
mesh_terms: D000328:Adult; D000368:Aged; D003431:Cross-Cultural Comparison; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000208:ethnology*; D012307:Risk Factors; D020521:Stroke / Q000208:ethnology*; D013781:Texas / Q000453:epidemiology; D044465:White People