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Said A. Ibrahim, MD, MPH, Jeff Whittle, MD, MPH, Bevanne Bean-Mayberry, MD, MS, Mary E. Kelley, MS, Chester Good, MD, MPH and Joseph Conigliaro, MD, MPH

Said A. Ibrahim, Bevanne Bean-Mayberry, Mary E. Kelley, Chester Good, and Joseph Conigliaro are with the Center for Health Equity Research and Promotion, Pittsburgh VA Healthcare System, University of Pittsburgh, Pittsburgh, Pa. Jeff Whittle is with the University of Kansas Medical Center, Kansas City, Kansas.

Correspondence: Requests for reprints should be sent to Said A. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA 15240 (e-mail: said.ibrahim2{at}med.va.gov).

Objectives. We sought to examine whether physician recommendations for cardiac revascularization vary according to patient race.

Methods. We studied patients scheduled for coronary angiography at 2 hospitals, one public and one private, between November 1997 and June 1999. Cardiologists were interviewed regarding their recommendations for cardiac resvacularization.

Results. African American patients were less likely than Whites to be recommended for revascularization at the public hospital (adjusted odds ratio [OR] = 0.31; 95% confidence interval [CI] = 0.12, 0.77) but not at the private hospital (adjusted OR = 1.69; 95% CI = 0.69, 4.14).

Conclusions. Physician recommendations for cardiac revascularization vary by patient race. Further studies are needed to examine physician bias as a factor in racial disparities in cardiac care and outcomes.

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