title: Increased Long-Term Mortality among Black CABG Patients Receiving Preoperative Inotropic Agents.
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.
authors.affiliation: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. jimmy.efird@stanfordalumni.org.|Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA. jimmy.efird@stanfordalumni.org.|Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA. jimmy.efird@stanfordalumni.org.
authors.forename: Jimmy T
authors.initials: JT
authors.lastname: Efird
authors.affiliation: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. griffinw11@students.ecu.edu.
authors.forename: William F
authors.initials: WF
authors.lastname: Griffin
authors.affiliation: Center for Minority Health and Health Disparities Research and Education, Xavier University of Louisiana, New Orleans, LA 70125, USA. dsarpong@xula.edu.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Sarpong
authors.affiliation: Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA. SD2WF@hscmail.mcc.virginia.edu.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Davies
authors.affiliation: Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA. vanni13@students.ecu.edu.
authors.forename: Iulia
authors.initials: I
authors.lastname: Vann
authors.affiliation: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. koutlasnate@gmail.com.
authors.forename: Nathaniel T
authors.initials: NT
authors.lastname: Koutlas
authors.affiliation: Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA. andersonet@ecu.edu.
authors.forename: Ethan J
authors.initials: EJ
authors.lastname: Anderson
authors.affiliation: The College of Nursing, East Carolina University, Greenville, NC 27834, USA. cranep14@ecu.edu.
authors.forename: Patricia B
authors.initials: PB
authors.lastname: Crane
authors.affiliation: Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA. landrineh@ecu.edu.
authors.forename: Hope
authors.initials: H
authors.lastname: Landrine
authors.affiliation: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. kindelll@ecu.edu.
authors.forename: Linda
authors.initials: L
authors.lastname: Kindell
authors.affiliation: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. iqbalz@ecu.edu.
authors.forename: Zahra J
authors.initials: ZJ
authors.lastname: Iqbal
authors.affiliation: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. fergusont@ecu.edu.
authors.forename: T Bruce
authors.initials: TB
authors.lastname: Ferguson
authors.affiliation: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. chitwoodw@ecu.edu.
authors.forename: W Randolph
authors.initials: WR
authors.lastname: Chitwood
authors.affiliation: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. kypsona@ecu.edu.
authors.forename: Alan P
authors.initials: AP
authors.lastname: Kypson
mesh_terms: D001741:Black or African American; D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D001026:Coronary Artery Bypass / Q000401:mortality*; D003324:Coronary Artery Disease / Q000208:ethnology*; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D044469:Racial Groups; D012189:Retrospective Studies; D012307:Risk Factors; D044465:White People
chemical_list: D002316:Cardiotonic Agents
keywords: cardiac surgery; disparities; heart disease; heart failure; inotropes; mortality