Abstract P162: Coronary Intervention Procedures in CAD Patients with Diabetes: Racial Disparities Are Associated with Post-Procedure Mortality
Background: The two major intervention treatment procedures for coronary artery disease (CAD) are coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with. Besides being a major risk factor for CAD, diabetes mellitus (DM) also impacts unfavorably CAD patients’ prognosis. We hypothesized that racial and socio-economic disparities are associated with post-procedure mortality in CAD patients with DM.
Methods: A retrospective cohort study of post-procedure mortality after CABG and PCI in 188,851 CAD patients with DM (mean age 65.5∓11.3 years, 35.3% women) was conducted. In-hospital patient death was a binary outcome of interest. Adjusted odds ratios (OR) were obtained from multivariable logistic regression, adjusted for a number of demographic, socio-economic and clinical confounders, including the severity of comorbid conditions (other than DM) measured by Elixhauser Comorbidity Index, Walraven modification. All results were analyzed with SAS version 9.2.
Results: Post-CABG in-hospital mortality was higher than post-PCI (adjusted OR 1.89, 95% CI: 1.72-2.08, p<0.01). Post-procedure mortality was associated with higher severity of co-existing conditions (10.6% increase for each point increase in Elixhauser-Walraven score, p<0.01) and emergency room (ER) admission (adjusted OR 1.10, 95% CI: 1.08-1.11, p<0.01). African Americans were more likely to undergo ER admission (43.7%) than other racial groups. ER admission was also significantly higher in lower socio-economic status groups, while severity of co-existing conditions was higher (p<0.01).
Conclusion: Racial and socio-economic disparities are associated with in-hospital mortality after coronary intervention procedures. Further investigation of mortality disparities in CAD patients with DM is warranted.
Author Disclosures: A.V. Sergeev: None.
- © 2014 by American Heart Association, Inc.