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Black patients suffer worse outcomes after PCI compared with white patients

Key clinical point: In a pooled analysis of randomized trials, minority patients had significantly more comorbidities than white patients.

Major finding: In a multivariate analysis, black race was independently associated with a 5-year risk for major adverse cardiac events (hazard ratio 1.28, P=0.01).

Study details: The data come from a review of 22,638 adult patients.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Commentary

“Numerous studies from registries and single centers have shown variation of outcomes by race after percutaneous coronary intervention (PCI). This analysis of pooled data from 10 randomized trials with a combined total of 22,638 patients who underwent PCI demonstrated race-based differences in outcomes. Black and Hispanic patients had greater clinical comorbidities and worse angiographic outcomes after PCI. In addition, black race was associated with increased risks for death (HR: 2.06; 95% CI: 1.26 to 3.36; p = 0.004) and myocardial infarction (MI) (HR: 1.45; 95% CI: 1.01 to 2.10; p = 0.045) at 1 year and increased risks for MI (HR: 1.55; 95% CI: 1.15 to 2.09; p = 0.004) and MACE (HR: 1.28; 95% CI: 1.05 to 1.57; p = 0.01) at 5 years. The study demonstrates racial disparities in outcomes after PCI even in modern era. There is a need to identify the underlying etiologies and develop methods to solve racial disparities in cardiovascular care.”

Luke Kim, MD

Weill Cornell Medical College/New York Presbyterian Hospital

Citation:

Golomb M. et al. J Am Coll Cardiol Intv. 2020 Jul 13. doi: 10.1016/j.jcin.2020.04.020.