Abstract 916: Association of a Unique Cardiovascular Risk Profile with Outcomes in Hispanic Patients Referred for PCI: Results from the NHLBI Dynamic Registry
Hispanics comprise the largest minority population in the United States, accounting for approximately 15% of the population; however, few data exist regarding the demographics and outcomes of Hispanic patients referred for percutaneous coronary intervention (PCI). Utilizing patients from the NHLBI Dynamic Registry Waves 1–5 (1999 to 2006), demographic features, angiographic data, and one year outcomes of Hispanic patients (n=542) vs. Caucasians (n=1357) undergoing PCI were evaluated. Only clinical centers where > 5% of patients reported to be of Hispanic ethnicity were included. Compared with Caucasians, despite Hispanic patients being younger (61.9 vs. 64.9 yrs, p < 0.001), they had more hypertension (80.4% vs. 72.3%, p < 0.001) and diabetes (49.2% vs. 27.8%, p < 0.001), including more insulin treated diabetes (15.0% vs. 7.4%, p < 0.001). Hispanic patients had less peripheral vascular disease (5.6% vs. 10.3%, p = 0.001), prior myocardial infarction (25.8% vs. 30.9%, p = 0.03), or prior percutaneous procedure (27.8% vs. 34.1%, p = 0.009). While the mean lesion length was longer in Hispanics (15.4 mm vs. 14.1 mm, p < 0.0001), there were no differences in the number of significant lesions (3.0 vs. 2.9, p = 0.43), or in the use of drug-eluting stents (29.1% vs. 29.8%, p = 0.72). Periprocedural and in-hospital outcomes were similar between the groups. Adjusted one year hazard ratios for adverse events for Hispanics vs. Caucasians are shown below. Hispanic patients referred for PCI have a unique set of cardiovascular risk factors compared to their Caucasian counterparts. Despite the presence of diabetes in almost 50% of Hispanic patients and longer lesion lengths than Caucasians, Hispanic patients were less likely to undergo CABG one year post PCI and had a trend toward lower rates of repeat revascularization. Whether these findings reflect referral bias or a tendency for less restenosis in Hispanic patients needs to be further studied.