Race and Ethnicity: Impact on cardiovascular outcomes after percutaneous coronary intervention

By Samar Mahmoud, MS
Published January 27, 2022

Key Takeaways

  • This single-center study found that, compared with White patients, there were no significant differences in cardiovascular outcomes for Hispanic and African American acute coronary syndrome (ACS) patients who received a percutaneous coronary intervention (PCI). 

  • Compared with White patients, Asian ACS patients had more favorable cardiovascular outcomes.

While cardiovascular disease is the leading cause of death worldwide, regardless of race/ethnicity, previous research has demonstrated differences in clinical and socioeconomic variables in minority ACS patients that may ultimately lead to disparities in clinical outcomes.

Why This Study Matters

To determine if race/ethnicity plays a role in cardiovascular outcomes, this study sought to evaluate adverse events in ACS patients stratified into White, African American, Hispanic, and Asian groups.

Study Design

The study included patients who underwent a PCI with drug-eluting stents for ST–segment elevation myocardial infarction (STEMI), non-STEMI, or unstable angina. Investigators classified patients into groups based on race and ethnicity, with White patients assigned as the reference group. 

The primary outcome of the study was a composite endpoint of death, spontaneous myocardial infarction, or stroke at 1 year. 

Results and Conclusions

The study consisted of 6800 patients, 49.7% 20.7%, 17.0%, and 12.6% were White, Hispanic, Asian, and African American, respectively. 

African American and Hispanic patients had the highest rates of STEMI while Asians were more likely to experience unstable angina. 

Compared with White patients, Asian patients had more favorable cardiac outcomes, with 7.1% of white patients experiencing a major adverse cardiac event at 1 year in comparison to 3.9% of Asian patients.  African American and Hispanic patients had similar outcomes to White patients, with 8% of African-American and 6.2% of Hispanic patients experiencing adverse outcomes. 

Related Research

Consider these findings from similar research studies:

  • In patients enrolled in coronary stent randomized controlled trials, Black race was a predictor of worse outcomes, while Hispanic ethnicity and Asian race were not (Source). 

  • Black patients had a 2-fold greater risk of adverse outcomes among adult survivors of a myocardial infarction (Source).

Original Source 

Roumeliotis A, Claessen B, Sartori S, et al. Impact of race/ethnicity on long term outcomes after percutaneous coronary intervention with drug-eluting stents. The American Journal of Cardiology. Published online January 2022:S0002914921011917.

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