TY - JOUR
T1 - The association between patient race, treatment, and outcomes of patients undergoing contemporary percutaneous coronary intervention
T2 - Insights from the blue cross blue shield of michigan cardiovascular consortium (BMC2)
AU - Khambatta, Sherezade
AU - Seth, Milan
AU - Rosman, Howard S.
AU - Share, David
AU - Aronow, Herbert D.
AU - Moscucci, Mauro
AU - LaLonde, Thomas
AU - Dixon, Simon R.
AU - Gurm, Hitinder S.
N1 - Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2013/6
Y1 - 2013/6
N2 - Background The aim of this study was to examine if racial disparities exist in the treatment and outcomes of patients undergoing contemporary percutaneous coronary intervention (PCI). Methods We examined the association between race, process of care, and outcomes of patients undergoing PCI between January 1, 2010, and December 31, 2011, and enrolled in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium. We used propensity matching to compare the outcome of black and white patients. Results The study cohort comprised 65,175 patients, of whom 6,873 (10.5%) were black and 55,789 (85.6%) were white. Black patients were more likely to be younger, be female, have more comorbidities, and be uninsured. Overall, black patients were less likely to receive prasugrel (10.0% vs 14.5%, P >.001) and drug-eluting stents (62.5% vs 67.7%, P >.001), largely related to lower use of these therapies in hospitals treating a higher proportion of black patients. No differences were seen between white and black patients with regard to inhospital mortality (odds ratio 1.34, 95% CI 0.82-2.2, P = .24), contrast-induced nephropathy (OR 1.06, 95% CI 0.81-1.40, P = .67), and need for transfusion (OR 1.27, 95% CI 0.98-1.64, P = .06). White race was associated with increased odds of heart failure (OR 1.48, 95% CI 1.05-2.08, P = .024) and vascular complications (OR 1.40, 95% CI 1.03-1.90, P = .032). Conclusions Compared with white patients, black patients undergoing PCI have a greater burden of comorbidities but, after adjusting for these differences, have similar inhospital survival and lower odds of vascular complications and heart failure after PCI. (Am Heart J 2013;165:893-901.e2.).
AB - Background The aim of this study was to examine if racial disparities exist in the treatment and outcomes of patients undergoing contemporary percutaneous coronary intervention (PCI). Methods We examined the association between race, process of care, and outcomes of patients undergoing PCI between January 1, 2010, and December 31, 2011, and enrolled in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium. We used propensity matching to compare the outcome of black and white patients. Results The study cohort comprised 65,175 patients, of whom 6,873 (10.5%) were black and 55,789 (85.6%) were white. Black patients were more likely to be younger, be female, have more comorbidities, and be uninsured. Overall, black patients were less likely to receive prasugrel (10.0% vs 14.5%, P >.001) and drug-eluting stents (62.5% vs 67.7%, P >.001), largely related to lower use of these therapies in hospitals treating a higher proportion of black patients. No differences were seen between white and black patients with regard to inhospital mortality (odds ratio 1.34, 95% CI 0.82-2.2, P = .24), contrast-induced nephropathy (OR 1.06, 95% CI 0.81-1.40, P = .67), and need for transfusion (OR 1.27, 95% CI 0.98-1.64, P = .06). White race was associated with increased odds of heart failure (OR 1.48, 95% CI 1.05-2.08, P = .024) and vascular complications (OR 1.40, 95% CI 1.03-1.90, P = .032). Conclusions Compared with white patients, black patients undergoing PCI have a greater burden of comorbidities but, after adjusting for these differences, have similar inhospital survival and lower odds of vascular complications and heart failure after PCI. (Am Heart J 2013;165:893-901.e2.).
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U2 - 10.1016/j.ahj.2013.02.030
DO - 10.1016/j.ahj.2013.02.030
M3 - Review article
C2 - 23708159
AN - SCOPUS:84880072757
VL - 165
SP - 893-901.e2
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 6
ER -