Abstract 490: Coronary CT Angiography and Racial Differences in Post-Test Resource Utilization: The ACIC Registry
Introduction: Significant racial disparities exist in the management of patients with suspected coronary artery disease (CAD). African American (AA) patients consistently exhibit poorer health outcomes due to CAD. The aim of this study was to evaluate whether racial disparities exist in resource utilization after coronary CT angiography (CCTA).
Methods: Consecutive Caucasian or AA patients without known CAD who underwent CCTA and were enrolled in a statewide quality control registry with complete 3-month follow-up were included. Racial differences in post-CCTA resource utilization were compared among patients with coronary stenosis ≤50% or >50% on CCTA.
Results: The study group included 6897 patients (87% Caucasian). AA patients were younger (mean age 51 vs. 56 years) with higher prevalence of hypertension (59% vs. 46%, p <0.0001), diabetes (17% vs. 12%, p <0.0001) and smoking (18 vs. 14%, p = 0.003). Obstructive CAD prevalence was lower in AA patients (10.6% vs. 19%, p <0.0001). Within each race, ≤50% stenosis on CCTA was associated with lower rate of downstream testing and hospitalization (Table⇓). Compared to Caucasians, AA patients demonstrated increased rates of emergency room visits and hospitalization irrespective of stenosis on CCTA (20% vs. 9%, p <0.0001), presumably due to persistent symptoms.
Conclusion: Although non-obstructive CAD on CCTA is associated with overall decreased downstream testing, a trend toward increased resource utilization was observed in AA patients after CCTA for suspected CAD. Further research is needed regarding the overall and socio-economic implications of these preliminary findings.