Ethnicity in Complex High-Risk but Indicated Percutaneous Coronary Intervention Types and

被引:8
作者
Shamkhani, Warkaa [1 ,2 ]
Kinnaird, Tim [1 ,3 ]
Wijeysundera, Harindra C. [4 ]
Ludman, Peter [5 ]
Rashid, Muhammad [1 ,2 ]
Mamas, Mamas A. [1 ,2 ]
机构
[1] Keele Univ, Keele Cardiovasc Res Grp, Ctr Prognosis Res, Inst Primary Care & Hlth Sci, Stoke On Trent, Staffs, England
[2] Royal Stoke Univ Hosp, Stoke On Trent, Staffs, England
[3] Univ Hosp Wales, Dept Cardiol, Cardiff, Wales
[4] Sunnybrook Hlth Sci Ctr, Dept Cardiol, Toronto, ON, Canada
[5] Queen Elizabeth Hosp, Birmingham, W Midlands, England
关键词
ACUTE MYOCARDIAL-INFARCTION; CHRONIC TOTAL OCCLUSION; HIGH BLEEDING RISK; OUTCOMES; CAUCASIANS; MORTALITY; IMPACT; RACE;
D O I
10.1016/j.amjcard.2022.03.056
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Complex High-risk but indicated Percutaneous coronary interventions (CHiPs) is increastypes, outcomes, and trends in patients with stable angina are limited; this is pertinent given the population of Black, Asian, and other ethnic minorities (BAME) in Europe is increasing. We conducted a retrospective analysis of CHiP procedures undertaken in patients with stable angina using data obtained from the BCIS (British Cardiovascular Intervention Society) registry (2006 to 2017). CHiP cases were identified and categorized by ethnicity into White and BAME groups. We then performed multivariable regression analysis and propensity score matching to determine adjusted odds ratios (aORs) of inhospital mortality, major bleeding, and major adverse cardiovascular and cerebral events (MACCEs) in BAME compared with Whites. Of 424,290 procedure records, 105,949 were CHiP (25.0%) (White 89,038 [84%], BAME 16,911 [16%]). BAME patients were younger (median 68.1 vs 70.6 years). Previous coronary artery bypass surgery (33.4% vs 38.3%), followed by chronic total occlusion percutaneous coronary intervention (31.9% vs 32%) were common CHiP variables in both groups. The third common variable was age 80 years and above (23.6%) in White patients and severe vascular calcifications in BAME patients (18.8%). BAME patients had higher rates of diabetes (41.1 vs 23.6%), hypertension (68 vs 66.5%), previous percutaneous coronary intervention (43.7 vs 37.6%), and previous myocardial infarction (44.9 vs 42.5%), (p < 0.001 for all). Mortality (aOR 1.1, 95% confidence interval [CI] 0.8 to 1.5) and MACCE (aOR 1.0, 95% CI 0.8 to 1.1) odds were similar among the groups. Bleeding odds (aOR 0.7, 95% CI 0.6 to 0.9) were lower in BAME. In conclusion, CHiP procedures differed among the ethnic groups. BAME patients were younger and had worse cardiometabolic profiles. Similar odds of death and MACCE were seen in BAME compared with their White counterparts. Bleeding odds were 30% lower in the BAME group. (C) 2022 Elsevier Inc. All rights reserved.
引用
收藏
页码:26 / 37
页数:12
相关论文
共 31 条
[1]   Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999-2014 [J].
Angraal, Suveen ;
Khera, Rohan ;
Wang, Yun ;
Lu, Yuan ;
Jean, Raymond ;
Dreyer, Rachel P. ;
Geirsson, Arnar ;
Desai, Nihar R. ;
Krumholz, Harlan M. .
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2018, 7 (14)
[2]   Reporting and representation of race/ethnicity in published randomixed trials [J].
Berger, Jeffrey S. ;
Melloni, Chiara ;
Wang, Tracy Y. ;
Dolor, Rowena J. ;
Frazier, Camille G. ;
Samad, Zainab ;
Peterson, Eric D. ;
Mark, Daniel B. ;
Newby, L. Kristin .
AMERICAN HEART JOURNAL, 2009, 158 (05) :742-747
[3]   Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention [J].
Brilakis, Emmanouil S. ;
Banerjee, Subhash ;
Karmpaliotis, Dimitri ;
Lombardi, William L. ;
Tsai, Thomas T. ;
Shunk, Kendrick A. ;
Kennedy, Kevin F. ;
Spertus, John A. ;
Holmes, David R., Jr. ;
Grantham, Aaron .
JACC-CARDIOVASCULAR INTERVENTIONS, 2015, 8 (02) :245-253
[4]   Risk of Major Adverse Cardiovascular Events and Major Hemorrhage Among White and Black Patients Undergoing Percutaneous Coronary Intervention [J].
Cai, Anping ;
Dillon, Chrisly ;
Hillegass, William B. ;
Beasley, Mark ;
Brott, Brigitta C. ;
Bittner, Vera A. ;
Perry, Gilbert J. ;
Halade, Ganesh V. ;
Prabhu, Sumanth D. ;
Limdi, Nita A. .
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2019, 8 (22)
[5]   Validation of the Academic Research Consortium High Bleeding Risk Definition in Contemporary PCI Patients [J].
Cao, Davide ;
Mehran, Roxana ;
Dangas, George ;
Baber, Usman ;
Sartori, Samantha ;
Chandiramani, Rishi ;
Stefanini, Giulio G. ;
Angiolillo, Dominick J. ;
Capodanno, Davide ;
Urban, Philip ;
Morice, Marie-Claude ;
Krucoff, Mitchell ;
Goel, Ridhima ;
Roumeliotis, Anastasios ;
Sweeny, Joseph ;
Sharma, Samin K. ;
Kini, Annapoorna .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2020, 75 (21) :2711-2722
[6]  
Chandiramani R, 2020, J AM COLL CARDIOL, V75, P1157
[7]   Prevalence, correlates, and impact of coronary calcification on adverse events following PCI with newer-generation DES: Findings from a large multiethnic registry [J].
Copeland-Halperin, Robert S. ;
Baber, Usman ;
Aquino, Melissa ;
Rajamanickam, Anitha ;
Roy, Swathi ;
Hasan, Choudhury ;
Barman, Nitin ;
Kovacic, Jason C. ;
Moreno, Pedro ;
Krishnan, Prakash ;
Sweeny, Joseph M. ;
Mehran, Roxana ;
Dangas, George ;
Kini, Annapoorna S. ;
Sharma, Samin K. .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2018, 91 (05) :859-866
[8]   Racial Differences in Risks for First Cardiovascular Events and Noncardiovascular Death The Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, and the Multi-Ethnic Study of Atherosclerosis [J].
Feinstein, Matthew ;
Ning, Hongyan ;
Kang, Joseph ;
Bertoni, Alain ;
Carnethon, Mercedes ;
Lloyd-Jones, Donald M. .
CIRCULATION, 2012, 126 (01) :50-+
[9]   Ethnicity and the first diagnosis of a wide range of cardiovascular diseases: Associations in a linked electronic health record cohort of 1 million patients [J].
George, Julie ;
Mathur, Rohini ;
Shah, Anoop Dinesh ;
Pujades-Rodriguez, Mar ;
Denaxas, Spiros ;
Smeeth, Liam ;
Timmis, Adam ;
Hemingway, Harry .
PLOS ONE, 2017, 12 (06)
[10]   Mortality in South Asians and Caucasians After Percutaneous Coronary Intervention in the United Kingdom [J].
Jones, Daniel A. ;
Gallagher, Sean ;
Rathod, Krishnaraj S. ;
Redwood, Simon ;
de Belder, Mark A. ;
Mathur, Anthony ;
Timmis, Adam D. ;
Ludman, Peter F. ;
Townend, John N. ;
Wragg, Andrew .
JACC-CARDIOVASCULAR INTERVENTIONS, 2014, 7 (04) :362-371