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Disparities in access, utilization, and outcomes of percutaneous coronary intervention in Hispanics compared to non-Hispanic Whites in the United States: A comprehensive review.
Cardiovasc Revasc Med. 2025 Dec; 81:144-153.CR

Abstract

BACKGROUND

Ischemic heart disease is the leading cause of cardiovascular mortality in the United States, with percutaneous coronary intervention (PCI) being one of the definitive treatments. Historically, data suggested Hispanics, when compared to non-Hispanic Whites, suffer worse acute coronary syndrome mortality rates. Therefore, we conducted a comprehensive literature review to summarize factors influencing PCI outcomes in this population.

METHODS

In accordance with PRISMA guidelines for systematic reviews, we performed a literature search encompassing PCI for any indication with Hispanic-specific outcomes using the PubMed database through April 2025 yielding 69 studies. Authors independently screened search results and resolved discrepancies through consensus. Meta-analysis was performed where ever feasible using random effects models due to expected study heterogeneity.

RESULTS/DATA

Hispanics experience acute myocardial infarction more frequently and are more likely to present urgently or emergently than Whites. Hispanic ethnicity correlates with delayed door-to-balloon and catheterization laboratory activation times. Additionally, Hispanics are disproportionately admitted to low procedure volume hospitals with disparities in hospital quality resulting in inferior PCI outcomes. High Medicaid and uninsured rates in Hispanics reflect cost-prohibitive healthcare access limitations, resulting in a trend towards lower rates of resvascularization and procedural differences like stent utilization. However, in-hospital and long-term outcomes between Hispanic and White populations undergoing PCI are similar.

CONCLUSION(S)

This review uncovers an incongruity between profound disparities in access and utilization of PCI, driven by socio-economic determinants, and comparable in-hospital and mortality outcomes between Hispanics and Whites. Consequently, it highlights the need for increased research to improve patient outcomes and reduce health disparities.

Authors+Show Affiliations

University of Texas Health Science Center - San Antonio, San Antonio, TX, United States of America.Division of Cardiology, University of New Mexico, Albuquerque, NM, United States of America.Division of Cardiology, University of New Mexico, Albuquerque, NM, United States of America.Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States of America.Division of Cardiology, University of New Mexico, Albuquerque, NM, United States of America. Electronic address: BYarlagadda@salud.unm.edu.

Pub Type(s)

Journal Article
Systematic Review
Meta-Analysis
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

41044036

Citation

Leung, Eric C H., et al. "Disparities in Access, Utilization, and Outcomes of Percutaneous Coronary Intervention in Hispanics Compared to non-Hispanic Whites in the United States: a Comprehensive Review." Cardiovascular Revascularization Medicine : Including Molecular Interventions, vol. 81, 2025, pp. 144-153.
Leung ECH, Blankenship JC, Orellana CP, et al. Disparities in access, utilization, and outcomes of percutaneous coronary intervention in Hispanics compared to non-Hispanic Whites in the United States: A comprehensive review. Cardiovasc Revasc Med. 2025;81:144-153.
Leung, E. C. H., Blankenship, J. C., Orellana, C. P., Hill, D., & Yarlagadda, B. (2025). Disparities in access, utilization, and outcomes of percutaneous coronary intervention in Hispanics compared to non-Hispanic Whites in the United States: A comprehensive review. Cardiovascular Revascularization Medicine : Including Molecular Interventions, 81, 144-153. https://doi.org/10.1016/j.carrev.2025.09.008
Leung ECH, et al. Disparities in Access, Utilization, and Outcomes of Percutaneous Coronary Intervention in Hispanics Compared to non-Hispanic Whites in the United States: a Comprehensive Review. Cardiovasc Revasc Med. 2025;81:144-153. PubMed PMID: 41044036.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disparities in access, utilization, and outcomes of percutaneous coronary intervention in Hispanics compared to non-Hispanic Whites in the United States: A comprehensive review. AU - Leung,Eric C H, AU - Blankenship,James C, AU - Orellana,Carolina Ponce, AU - Hill,Deirdre, AU - Yarlagadda,Bharath, Y1 - 2025/09/23/ PY - 2025/03/27/received PY - 2025/08/29/revised PY - 2025/09/18/accepted PY - 2025/12/13/medline PY - 2025/10/4/pubmed PY - 2025/10/3/entrez KW - Hispanics KW - Ischemic heart disease KW - Minority health disparities KW - Percutaneous coronary intervention KW - Social determinants SP - 144 EP - 153 JF - Cardiovascular revascularization medicine : including molecular interventions JO - Cardiovasc Revasc Med VL - 81 N2 - BACKGROUND: Ischemic heart disease is the leading cause of cardiovascular mortality in the United States, with percutaneous coronary intervention (PCI) being one of the definitive treatments. Historically, data suggested Hispanics, when compared to non-Hispanic Whites, suffer worse acute coronary syndrome mortality rates. Therefore, we conducted a comprehensive literature review to summarize factors influencing PCI outcomes in this population. METHODS: In accordance with PRISMA guidelines for systematic reviews, we performed a literature search encompassing PCI for any indication with Hispanic-specific outcomes using the PubMed database through April 2025 yielding 69 studies. Authors independently screened search results and resolved discrepancies through consensus. Meta-analysis was performed where ever feasible using random effects models due to expected study heterogeneity. RESULTS/DATA: Hispanics experience acute myocardial infarction more frequently and are more likely to present urgently or emergently than Whites. Hispanic ethnicity correlates with delayed door-to-balloon and catheterization laboratory activation times. Additionally, Hispanics are disproportionately admitted to low procedure volume hospitals with disparities in hospital quality resulting in inferior PCI outcomes. High Medicaid and uninsured rates in Hispanics reflect cost-prohibitive healthcare access limitations, resulting in a trend towards lower rates of resvascularization and procedural differences like stent utilization. However, in-hospital and long-term outcomes between Hispanic and White populations undergoing PCI are similar. CONCLUSION(S): This review uncovers an incongruity between profound disparities in access and utilization of PCI, driven by socio-economic determinants, and comparable in-hospital and mortality outcomes between Hispanics and Whites. Consequently, it highlights the need for increased research to improve patient outcomes and reduce health disparities. SN - 1878-0938 UR - https://www.unboundmedicine.com/medline/citation/41044036/Disparities_in_access DB - PRIME DP - Unbound Medicine ER -