Evidence map›Paper›PMID 39378232›Full record

ArticlePloS one2024

Financial resources, access to care, and quality of care mediate racial disparities in statin usage for secondary prevention.

Christopher Wong, Lyndonna Marrast, Rehana Rasul, Ratnam Srivastava, Jeffrey Kuvin, Robert Roswell, Joseph Conigliaro, Eun Ji Kim

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Christopher WongDivision of Cardiology, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey, United States of America.ORCID 0000-0001-7907-3859
Lyndonna MarrastDivision of General Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York, United States of America.
Rehana RasulDepartment of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, New York, United States of America.
Ratnam SrivastavaDivision of General Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York, United States of America.
Jeffrey KuvinDepartment of Cardiology, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, United States of America.
Robert RoswellLennox Hill Hospital, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States of America.ORCID 0000-0003-4358-6534
Joseph ConigliaroDivision of General Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York, United States of America.
Eun Ji KimDivision of General Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are disparities in statin therapy for the secondary prevention of atherosclerotic cardiovascular disease (ASCVD). The role of structural racism in this disparity has not been examined.

methodsThis is a cross-sectional study of participants with ASCVD in the Medical Expenditure Panel Survey from 2014-2017. Mediation analysis is utilized to estimate the direct effect of race and indirect effect of financial resources, access to care, and quality of care on statin usage.

resultsThe proportion of participants using statins by race/ethnicity were 58.5% for non-Hispanic Whites, 45% for Hispanics, 48.6% for Blacks, 61.6% for Asians, and 46.8% for Others. Statin usage was lower for Hispanics (OR = 0.79, 95% confidence interval [0.65-0.96]) and Blacks (OR = 0.80 [0.66-0.95]) compared to Whites. Hispanic, Black, and Other participants with the same financial resources, access to care, and quality of care as White participants did not have significantly different statin usage compared to White participants (Hispanic: OR = 0.98 [0.79-1.13]; Black (OR = 0.88 [0.76-1.06], Other: OR 0.76, 95% CI [0.56-1.15]). Hispanic, Black, and Other participants had significantly lower statin usage than subjects of the same race but with financial resources, access to care, and quality of care observed in White subjects (Hispanic: OR = 0.83 [0.83-0.92]; Black: OR = 0.91[0.88-0.94]; Other: OR = 0.92 [0.87-0.98]). DISCUSSION: The indirect effect of race and ethnicity on statin therapy are significant but the direct effect of race and ethnicity on statin therapy are insignificant among Blacks and Hispanics compared to non-Hispanic Whites. This suggests that racial disparities in statin therapy are mediated through inequitably distributed resources, suggestive of the impact of structural racism.

Indexed as

Healthcare DisparitiesHealth Services AccessibilityHydroxymethylglutaryl-CoA Reductase InhibitorsQuality of Health CareSecondary PreventionAdultAgedAtherosclerosisBlack or African AmericanCross-Sectional StudiesFemaleHispanic or LatinoHumansMaleMiddle AgedUnited StatesHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID39378232
PMCPMC11460713

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.