Abstract
Background: There is limited data on racial differences in long term cardiovascular (CV) outcomes amongst U.S. veterans. Methods: Utilizing the VA Informatics and Computing Infrastructure and the Corporate Data Warehouse we compared 10-year predicted major adverse CV events [MACE, a composite of all-cause death and non-fatal myocardial infarction] in patients referred for cardiovascular consultation between 2003 and 2009 using the SMART risk score with observed rates across racial groups. The SMART risk score classified patients into low 0-9.9%, intermediate 10-19.9%, high 20-29.9%, and very high >=30% risk groups. Results: 473,136 patients including white (74.7%), African American (15.5%), and other (9.8%) made the study cohort. Observed event rates were significantly higher in African Americans compared with Whites across all SMART risk groups [p<0.001], and highest in the other races, inclusive of Hispanics. These results are depicted in Figure 1 . Conclusion: There is a significantly higher observed 10-year MACE rate in African American veterans compared with their white counterparts across all predicted SMART risk score groups.
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