According to the Center for Disease Control (CDC), over 20 million Americans over the age of 20 have coronary artery disease (CAD).1 CAD ranks in the top 15 of the most expensive health conditions treated in the US - totaling over $230 million dollars and 12,000 hospital stays in 2017.2 Sadly, heart disease remains the leading cause of mortality in men and second leading cause in women.1 The standard of care for CAD is a coronary artery bypass graft (CABG), with 371,000 CABG procedures performed in 2014 alone.3,4 CABG procedures are common with low mortality rates and are effective in lowering heart attack risk and CAD symptoms years after surgery.5,6 Given the high prevalence of CAD, the need for efficacious CABG procedures and equal access to them is paramount; however, certain factors such as race, ethnicity, gender, and socioeconomic status (SES) may lead to disparity in receiving this treatment.7

Numerous studies have been conducted examining the effects of health inequities regarding CABG patients. Kressin et al. examined racial differences in procedure rates and found lower rates of CABG procedures in Blacks, Hispanics, and Asians when compared to white patients.8 Konety et al. found Black patients were more likely to undergo CABG procedures at hospitals with a higher mortality rate and experience higher mortality rates up to 1 year following the operation.9 These studies demonstrate that discrepancies exist in access to and receiving CABG operations, however, these inequities are not limited to race and ethnicity. The American Heart Association found that people who reported low income and education levels had twice the incidence of CAD.4 Despite this, studies show patients in areas of low health literacy or with low SES status were less likely to receive CABG treatment or be admitted to hospitals that perform CABG procedures.10,11 Further, certain groups – namely LGBTQ+ individuals and Native Americans – have a significantly smaller research base from which to draw conclusions. This is a concerning trend, as members of each community experience higher risk for the development of cardiovascular disease. Individuals in the Native American population have higher rates of tobacco abuse and obesity, significant risk factors for the development of CAD.12, 13, 14 Members of the LGBTQ+ community also have higher risk factors, such as substance and alcohol abuse.15,16

Given that these inequities exist at important demographic intersections of race, gender, and SES, further research is warranted into mapping how CABG literature assesses these demographic factors. The purpose of this scoping review is to investigate the CABG literature germane to the demographic groups of interest. Our goal is to build upon the evidence base of CABG literature assessing disparity while providing a comprehensive review of existing literature.