Racial Disparities in Clinical Characteristics and Outcomes of Women Undergoing Percutaneous Coronary Intervention.

Racial Disparities in Clinical Characteristics and Outcomes of Women Undergoing Percutaneous Coronary Intervention. - 2019

Available in print through MWHC library: 2002 - present

BACKGROUND/PURPOSE: Women are underrepresented in cardiovascular clinical studies. Black women have a higher ischemic heart disease mortality risk than their white counterparts. However, there exist limited outcome data comparing black women and white women after percutaneous coronary intervention (PCI). The aim of this retrospective analysis was to evaluate for racial disparities in 1-year major adverse cardiovascular events (MACE) in women undergoing PCI. CONCLUSIONS: In this large cohort of women with coronary artery disease undergoing PCI, we observed racial disparities primarily in baseline characteristics indicative of need for interventions to achieve early diagnosis and better prevention in black women. Future directions should include efforts to identify and better characterize the factors underlying and contributing to cardiovascular outcomes in women after PCI. METHODS/MATERIALS: Within our PCI database, we identified 4776 female patients who underwent PCI between 2003 and 2016. Of those, 1916 were black and 2860 were white. Endpoints included MACE, death, myocardial infarction, target vessel revascularization (TVR) and stent thrombosis (ST) at 30days and 1year. A proportional Cox hazard model analysis was performed to assess outcomes after adjustment for confounding factors. RESULTS: Black women presented at a younger age and had a significantly higher prevalence of risk factors. Periprocedural and in-hospital outcomes were similar in the 2 groups. At 30days and 1year, the rates of myocardial infarction, TVR and ST were significantly higher in black women. After adjustment for baseline differences, only ST appears to be more likely to occur in black women than in white women. SUMMARY: In this real-world analysis from a large cohort of women with coronary artery disease undergoing percutaneous coronary intervention at a US tertiary-care center, racial disparities were observed, especially in baseline characteristics, indicating late presentation. Copyright (c) 2019 Elsevier Inc. All rights reserved.


English

1878-0938

10.1016/j.carrev.2019.09.020 [doi] S1553-8389(19)30645-1 [pii]


*African Americans
*Coronary Artery Disease/th [Therapy]
*European Continental Ancestry Group
*Health Status Disparities
*Healthcare Disparities/eh [Ethnology]
*Percutaneous Coronary Intervention
Aged
Aged, 80 and over
Coronary Artery Disease/di [Diagnosis]
Coronary Artery Disease/eh [Ethnology]
Coronary Artery Disease/mo [Mortality]
Databases, Factual
Female
Humans
Middle Aged
Percutaneous Coronary Intervention/ae [Adverse Effects]
Percutaneous Coronary Intervention/mo [Mortality]
Race Factors
Retrospective Studies
Risk Assessment
Risk Factors
Sex Factors
Treatment Outcome
United States/ep [Epidemiology]


MedStar Heart & Vascular Institute


Journal Article

Powered by Koha