Background and Purpose: 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.
Lewis B. Morgenstern, MD
Department of Neurology, The University of Texas, Houston
6431 Fannin, Room 7.044, Houston, TX 77030 (USA)
Tel. +1 713 500 7078, Fax +1 713 500 7019
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 4, Number of References : 22
Founded 1982 by B.S. Schoenberg, continued by M. Alter (1989–1996)
Vol. 18, No. 5, Year 1999 (Cover Date: September -October 1999)
Journal Editor: P.B. Gorelick, Chicago, Ill.
ISSN: 0251–5350 (print), 1423–0208 (Online)
For additional information: http://www.karger.com/journals/ned
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