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Racial disparities in outcomes following percutaneous coronary intervention with drug-eluting stents.
Am J Cardiol. 2009 Mar 01; 103(5):653-8.AJ

Abstract

Previous research has documented that African-Americans compared with non-African-Americans have higher rates of adverse cardiac outcomes and are less likely to be referred for an invasive cardiac procedure. These differences persist even after controlling for co-morbidities and socioeconomic status. We sought to compare 1-year outcomes between African-American and non-African-American patients in a clinical registry of patients after percutaneous coronary intervention receiving drug-eluting stents. We compared 1,221 African-American patients with 4,335 non-African-American patients referred for percutaneous coronary intervention. Patients were followed for 1 year with regard to major adverse cardiac events, including death, Q-wave myocardial infarction, and target vessel revascularization. We performed multivariable Cox proportional hazards regression to adjust for confounding variables, including median household income by zip code, to assess the contribution of African-American race to 1-year outcomes. At 1 year, African-American patients had significantly higher rates of overall major adverse cardiac events (17.7% African-American vs 12.4% non-African-American, p <0.001) and each component of death (7.8% African-American vs 5.4% non-African-American, p = 0.001), Q-wave myocardial infarction (1.2% African-American vs 0.2% non-African-American, p <0.001), and target vessel revascularization (10.7% African-American vs 7.5% non-African-American, p <0.001). Stent thrombosis was also higher in the African-American population at 1 year (2.5% African-American vs 0.7% non-African-American, p <0.001). After multivariable analysis and adjustment for socioeconomic status, however, African-American race was not a significant predictor of major adverse cardiac events. In conclusion, in this referral population, traditional risk factors and socioeconomic status accounted for the disparity between African-American and non-African-American patients.

Authors+Show Affiliations

Washington Hospital Center, Washington, DC, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19231328

Citation

Gaglia, Michael A., et al. "Racial Disparities in Outcomes Following Percutaneous Coronary Intervention With Drug-eluting Stents." The American Journal of Cardiology, vol. 103, no. 5, 2009, pp. 653-8.
Gaglia MA, Steinberg DH, Pinto Slottow TL, et al. Racial disparities in outcomes following percutaneous coronary intervention with drug-eluting stents. Am J Cardiol. 2009;103(5):653-8.
Gaglia, M. A., Steinberg, D. H., Pinto Slottow, T. L., Roy, P. K., Bonello, L., Delabriolle, A., Lemesle, G., Okabe, T., Torguson, R., Kaneshige, K., Xue, Z., Suddath, W. O., Kent, K. M., Satler, L. F., Pichard, A. D., Lindsay, J., & Waksman, R. (2009). Racial disparities in outcomes following percutaneous coronary intervention with drug-eluting stents. The American Journal of Cardiology, 103(5), 653-8. https://doi.org/10.1016/j.amjcard.2008.10.043
Gaglia MA, et al. Racial Disparities in Outcomes Following Percutaneous Coronary Intervention With Drug-eluting Stents. Am J Cardiol. 2009 Mar 1;103(5):653-8. PubMed PMID: 19231328.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial disparities in outcomes following percutaneous coronary intervention with drug-eluting stents. AU - Gaglia,Michael A,Jr AU - Steinberg,Daniel H, AU - Pinto Slottow,Tina L, AU - Roy,Probal K, AU - Bonello,Laurent, AU - Delabriolle,Axel, AU - Lemesle,Gilles, AU - Okabe,Teruo, AU - Torguson,Rebecca, AU - Kaneshige,Kimberly, AU - Xue,Zhenyi, AU - Suddath,William O, AU - Kent,Kenneth M, AU - Satler,Lowell F, AU - Pichard,Augusto D, AU - Lindsay,Joseph, AU - Waksman,Ron, Y1 - 2009/01/17/ PY - 2008/08/25/received PY - 2008/10/25/revised PY - 2008/10/25/accepted PY - 2009/2/24/entrez PY - 2009/2/24/pubmed PY - 2009/3/28/medline SP - 653 EP - 8 JF - The American journal of cardiology JO - Am J Cardiol VL - 103 IS - 5 N2 - Previous research has documented that African-Americans compared with non-African-Americans have higher rates of adverse cardiac outcomes and are less likely to be referred for an invasive cardiac procedure. These differences persist even after controlling for co-morbidities and socioeconomic status. We sought to compare 1-year outcomes between African-American and non-African-American patients in a clinical registry of patients after percutaneous coronary intervention receiving drug-eluting stents. We compared 1,221 African-American patients with 4,335 non-African-American patients referred for percutaneous coronary intervention. Patients were followed for 1 year with regard to major adverse cardiac events, including death, Q-wave myocardial infarction, and target vessel revascularization. We performed multivariable Cox proportional hazards regression to adjust for confounding variables, including median household income by zip code, to assess the contribution of African-American race to 1-year outcomes. At 1 year, African-American patients had significantly higher rates of overall major adverse cardiac events (17.7% African-American vs 12.4% non-African-American, p <0.001) and each component of death (7.8% African-American vs 5.4% non-African-American, p = 0.001), Q-wave myocardial infarction (1.2% African-American vs 0.2% non-African-American, p <0.001), and target vessel revascularization (10.7% African-American vs 7.5% non-African-American, p <0.001). Stent thrombosis was also higher in the African-American population at 1 year (2.5% African-American vs 0.7% non-African-American, p <0.001). After multivariable analysis and adjustment for socioeconomic status, however, African-American race was not a significant predictor of major adverse cardiac events. In conclusion, in this referral population, traditional risk factors and socioeconomic status accounted for the disparity between African-American and non-African-American patients. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/19231328/Racial_disparities_in_outcomes_following_percutaneous_coronary_intervention_with_drug_eluting_stents_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(08)01996-6 DB - PRIME DP - Unbound Medicine ER -