The purpose of this study was to investigate acute coronary syndromes (ACS) in elderly persons of different races. A prospective study was performed in which 177 consecutive unselected patients aged > or = 70 years hospitalized for ACS had coronary angiography. The patients included 11 blacks, 140 whites, and 26 patients of other races. Obstructive coronary artery disease (CAD) was present in 8 of 11 blacks (73%), 121 of 140 whites (86%), and 25 of 26 patients of other races (96%) (P < 0.05 comparing black patients with those of other races). Left main CAD was present in 0 of 11 blacks (0%), 9 of 140 whites (6%), and in 1 of 26 patients of other races (4%) (P not significant). Left anterior descending or diagonal CAD was present in 4 of 11 blacks (36%), 96 of 140 whites (67%), and 18 of 26 patients of other races (69%) (P < 0.05 comparing blacks with whites). Left circumflex or obtuse marginal disease was present in 5 of 11 blacks (45%), 72 of 140 whites (51%), and in 17 of 26 patients of other races (65%) (P not significant). Right CAD was present in 5 of 11 blacks (45%), 81 of 140 whites (58%), and 18 of 26 patients of other races (69%) (P not significant). Coronary revascularization was performed in 7 of 11 blacks (64%), 72 of 140 whites (52%), and 17 of 26 patients of other races (66%) (P not significant).
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