Greater stroke rate during hospitalization for acute heart disease among Mexican Americans than non-Hispanic whites.
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.
Morgenstern
L B
LB
Department of Neurology, The University of Texas Medical School at Houston, Houston, TX 77030, USA. 1morgens@neuro.med.uth.tmc.edu
Pandey
D K
DK
Smith
M A
MA
Ramsey
D
D
Labarthe
D R
DR
Nichaman
M Z
MZ
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