Racial Differences in the Trends, Clinical Characteristics and Outcomes of Patients Undergoing Coronary Atherectomy

Racial disparities persist in cardiovascular care, but little is known about differences in outcomes following coronary atherectomy by race or ethnicity. This study examines in-hospital outcomes and utilization trends of coronary atherectomy among Non-Hispanic Black (NHB) and Non-Hispanic White (NHW) patients using data from the National Inpatient Sample database (2016-2021). NHB patients were younger and exhibited a higher prevalence of comorbidities such as diabetes, hypertension, and chronic kidney disease compared with NHW patients. Despite this, multivariate analyses revealed that NHB patients had lower odds of in-hospital mortality (adjusted odds ratio [aOR]: 0.80; 95% CI: 0.68-0.95), cardiogenic shock (aOR: 0.84; 95% CI: 0.75-0.95), and percutaneous left ventricular assist device use (aOR: 0.87; 95% CI: 0.76-0.99) compared with NHW patients. However, NHB patients are associated with higher odds of acute kidney injury (aOR: 1.13; 95% CI: 1.02-1.24). Notably, among patients with a high comorbidity burden (Elixhauser score ≥4), NHB patients maintained a mortality advantage (OR: 0.82; 95% CI: 0.70-0.96). Coronary atherectomy utilization increased for both groups from 2016 to 2021. Our findings highlight the complex interaction between racial disparities, sex and clinical outcomes, emphasizing the need for further research to understand these trends and improve targeted strategies for equitable cardiovascular care.