Abstract 2098: Racial Disparities in Outcomes Following Percutaneous Coronary Intervention with Drug-Eluting Stents
Background: Previous research has documented that African-Americans (AA), when compared to non-African-Americans (non-AA), 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 comorbidities and socioeconomic status.
Methods: We compared 1221 AA patients to 4335 non-AA patients referred for percutaneous coronary intervention (PCI). Patients were followed for one year with regard to major adverse cardiac events (MACE), including death, Q-wave myocardial infarction (MI), and target vessel revascularization (TVR). 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 one-year outcomes.
Results: At one year, AA patients experienced significantly higher rates of overall TVR-MACE (17.7% AA vs. 12.4% non-AA, p<0.001) as well as each individual component of death (7.8% AA vs. 5.4% non-AA, p=0.001), Q-wave MI (1.2% AAvs. 0.2% non-AA, p<0.001) and TVR (10.7% AA vs. 7.5% non-AA, p<0.001). Stent thrombosis was also higher in the AA population at one year (2.5% AA vs. 0.7% non-AA, p<0.001). After multivariable analysis and adjustment for socioeconomic status, however, African-American race was not a significant predictor of MACE (Figure⇓).
Conclusion: In this referral population, traditional risk factors and socioeconomic status accounted for the disparity between AA and non-AA patients.