Care of Patients with or at Risk for Ischemic Heart DiseaseDisparities in patients presenting to the emergency department with potential acute coronary syndrome: It matters if you are Black or White

ObjectivesTo explore disparities between non-Hispanic Blacks and non-Hispanic Whites presenting to the emergency department (ED) with potential acute coronary syndrome (ACS).BackgroundIndividuals with fewer resources have worse health outcomes and these individuals are disproportionately those of color.MethodsThis prospective study enrolled 663 patients in four EDs. Clinical presentation, treatment, and patient-reported outcome variables were measured at baseline, 1, and 6 months.ResultsBlacks with confirmed ACS were younger; had lower income; less education; more risk factors; more symptoms, and longer prehospital delay at presentation compared to Whites. Blacks experiencing palpitations, unusual fatigue, and chest pain were more than 3 times as likely as Whites to have ACS confirmed. Blacks with ACS had more clinic visits and more symptoms 1 month following discharge.ConclusionsSignificant racial disparities remain in clinical presentation and outcomes for Blacks compared to Whites presenting to the ED with symptoms suggestive of ACS.