Effect of race and ethnicity on outcomes with drug-eluting and bare metal stents: results in 423 965 patients in the...

Area of Science:

• Cardiovascular Medicine
• Health Disparities
• Interventional Cardiology

Background:

• Percutaneous coronary intervention (PCI) trials have historically underrepresented Black, Hispanic, and Asian populations.
• Limited data exist on PCI outcomes across diverse racial and ethnic groups.

Purpose of the Study:

• To examine long-term outcomes of percutaneous coronary intervention (PCI) in Black, Hispanic, and Asian patients compared to white patients.
• To evaluate the comparative effectiveness of drug-eluting stents (DES) versus bare metal stents (BMS) across different racial and ethnic groups.

Main Methods:

• Analysis of 423,965 patients from the National Cardiovascular Data Registry CathPCI Registry linked to Medicare claims.
• Inclusion of patients >65 years undergoing stent implantation between 2004-2008.
• Examination of trends in DES use and 30-month outcomes, comparing DES to BMS within racial/ethnic groups.

Main Results:

• Black and Hispanic patients showed higher long-term risks of death and myocardial infarction compared to white patients.
• Asian patients had similar long-term outcomes to white patients.
• Drug-eluting stent (DES) use was associated with improved 30-month survival and reduced myocardial infarction rates across most groups, except for Hispanic patients who had similar outcomes with DES and bare metal stents.

Conclusions:

• Black and Hispanic patients undergoing PCI experience worse long-term outcomes relative to white and Asian patients.
• Drug-eluting stent (DES) use generally offers superior long-term outcomes compared to bare metal stents (BMS) in most racial and ethnic groups, with non-significant differences noted in Hispanic patients.