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Racial difference in cardiovascular outcomes following percutaneous coronary intervention in a public health service patient population.
J Invasive Cardiol. 2010 Apr; 22(4):168-73.JI

Abstract

BACKGROUND

Prior studies have reported conflicting findings regarding racial disparities in long-term cardiovascular outcomes after percutaneous coronary intervention (PCI). Our aim was to compare major adverse cardiac events (MACE) following PCI in black versus non-black patients in a Public Health Service (PHS) setting.

METHODS

A cohort of 1,438 consecutive patients undergoing intended PCI at a large public teaching hospital between April 2002 and September 2006 were followed for the development of MACE, defined as a composite of death, myocardial infarction (MI) and urgent target vessel revascularization.

RESULTS

The study population consisted of 47.4% blacks, 21.3% whites, 15.2% Hispanics and 16.1% Asians. Overall, 17.4% of patients developed MACE over the mean followup period of 2.9 years. The rate of MACE was significantly higher in blacks compared with non-blacks (21.7% vs. 13.6%, log-rank p < 0.001). After adjusting for age, gender, cardiovascular risk factors, socioeconomic status (SES) and potential confounding factors, black race remained a strong and independent predictor of MACE (adjusted HR, 1.52; CI, 1.18-1.96; p = 0.001). Blacks had higher rates of death (12.3% vs. 5.2%, log-rank p < 0.001) and MI (8.7% vs. 4.4%, log rank p = 0.002). There were no racial differences in in-hospital mortality and 3-month and 6-month MACE.

CONCLUSIONS

In this PHS population, blacks were found to have worse long-term cardiovascular outcomes and mortality following PCI, irrespective of differences in baseline cardiovascular risk factors, SES and health-care access.

Authors+Show Affiliations

Division of Cardiology, Department of Medicine, John H Stroger, Jr Hospital of Cook County, Chicago, Illinois, USA. snapan@howard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20351387

Citation

Napan, Sirikarn, et al. "Racial Difference in Cardiovascular Outcomes Following Percutaneous Coronary Intervention in a Public Health Service Patient Population." The Journal of Invasive Cardiology, vol. 22, no. 4, 2010, pp. 168-73.
Napan S, Kashinath R, Orig M, et al. Racial difference in cardiovascular outcomes following percutaneous coronary intervention in a public health service patient population. J Invasive Cardiol. 2010;22(4):168-73.
Napan, S., Kashinath, R., Orig, M., Kadri, S., & Khadra, S. (2010). Racial difference in cardiovascular outcomes following percutaneous coronary intervention in a public health service patient population. The Journal of Invasive Cardiology, 22(4), 168-73.
Napan S, et al. Racial Difference in Cardiovascular Outcomes Following Percutaneous Coronary Intervention in a Public Health Service Patient Population. J Invasive Cardiol. 2010;22(4):168-73. PubMed PMID: 20351387.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial difference in cardiovascular outcomes following percutaneous coronary intervention in a public health service patient population. AU - Napan,Sirikarn, AU - Kashinath,Ramesh, AU - Orig,Maria, AU - Kadri,Sameer, AU - Khadra,Suhail, PY - 2010/3/31/entrez PY - 2010/3/31/pubmed PY - 2010/8/31/medline SP - 168 EP - 73 JF - The Journal of invasive cardiology JO - J Invasive Cardiol VL - 22 IS - 4 N2 - BACKGROUND: Prior studies have reported conflicting findings regarding racial disparities in long-term cardiovascular outcomes after percutaneous coronary intervention (PCI). Our aim was to compare major adverse cardiac events (MACE) following PCI in black versus non-black patients in a Public Health Service (PHS) setting. METHODS: A cohort of 1,438 consecutive patients undergoing intended PCI at a large public teaching hospital between April 2002 and September 2006 were followed for the development of MACE, defined as a composite of death, myocardial infarction (MI) and urgent target vessel revascularization. RESULTS: The study population consisted of 47.4% blacks, 21.3% whites, 15.2% Hispanics and 16.1% Asians. Overall, 17.4% of patients developed MACE over the mean followup period of 2.9 years. The rate of MACE was significantly higher in blacks compared with non-blacks (21.7% vs. 13.6%, log-rank p < 0.001). After adjusting for age, gender, cardiovascular risk factors, socioeconomic status (SES) and potential confounding factors, black race remained a strong and independent predictor of MACE (adjusted HR, 1.52; CI, 1.18-1.96; p = 0.001). Blacks had higher rates of death (12.3% vs. 5.2%, log-rank p < 0.001) and MI (8.7% vs. 4.4%, log rank p = 0.002). There were no racial differences in in-hospital mortality and 3-month and 6-month MACE. CONCLUSIONS: In this PHS population, blacks were found to have worse long-term cardiovascular outcomes and mortality following PCI, irrespective of differences in baseline cardiovascular risk factors, SES and health-care access. SN - 1557-2501 UR - https://www.unboundmedicine.com/medline/citation/20351387/Racial_difference_in_cardiovascular_outcomes_following_percutaneous_coronary_intervention_in_a_public_health_service_patient_population_ L2 - http://www.invasivecardiology.com/articles/Racial-Difference-Cardiovascular-Outcomes-Following-Percutaneous-Coronary-Intervention-see- DB - PRIME DP - Unbound Medicine ER -