Coronary artery disease| Volume 104, ISSUE 6, P775-779, September 15, 2009

Association of a Unique Cardiovascular Risk Profile With Outcomes in Hispanic Patients Referred for Percutaneous Coronary Intervention (from the National Heart, Lung, and Blood Institute Dynamic Registry)

      Although previous studies have demonstrated that Hispanic patients have a higher cardiovascular risk profile than Caucasians and present at a younger age for percutaneous coronary intervention (PCI), limited studies exist examining the outcomes of Hispanics after PCI and potential explanations for differences noted. Using patients from the National Heart, Lung, and Blood Institute Dynamic Registry waves 1 to 5 (1997 to 2006), demographic features, angiographic data, and 1-year outcomes of Hispanic patients (n = 542) versus Caucasian patients (n = 1,357) undergoing PCI were evaluated. Compared to Caucasians, Hispanic patients were younger and had more hypertension and diabetes mellitus, including more insulin-treated diabetes mellitus. Although mean lesion length was longer in Hispanics (15.4 vs 14.1 mm, p <0.001), there were no differences in the number of significant lesions or in the use of drug-eluting stents. At follow-up, Hispanics were more likely to report recent anginal symptoms but had a similar incidence of 1-year hospitalizations for angina. Adjusted 1-year hazard ratios for adverse events for Hispanics versus Caucasians revealed lower rates of coronary artery bypass graft surgery (hazard ratio 0.43, confidence interval 0.22 to 0.85, p = 0.02) and a trend toward lower rates of repeat revascularization (hazard ratio 0.76, confidence interval 0.57 to 1.03, p = 0.08). In conclusion, despite the presence of diabetes in almost 50% of Hispanic patients and longer lesions than in Caucasians, Hispanic patients were less likely to undergo coronary artery bypass graft surgery 1 year after PCI and had a trend toward lower rates of repeat revascularization.
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        • Shaw L.J.
        • Shaw R.E.
        • Merz C.N.
        • Brindis R.G.
        • Klein L.W.
        • Nallamothu B.
        • Douglas P.S.
        • Krone R.J.
        • McKay C.R.
        • Block P.C.
        • Hewitt K.
        • Weintraub W.S.
        • Peterson E.D.
        • American College of Cardiology–National Cardiovascular Data Registry Investigators
        Impact of ethnicity and gender differences on angiographic coronary artery disease prevalence and in-hospital mortality in the American College of Cardiology–National Cardiovascular Data Registry.
        Circulation. 2008; 117: 1787-1801
        • Slater J.
        • Selzer F.
        • Dorbala S.
        • Tormey D.
        • Vlachos H.A.
        • Wilensky R.L.
        • Jacobs A.K.
        • Laskey W.K.
        • Douglas Jr, J.S.
        • Williams D.O.
        • Kelsey S.F.
        Ethnic differences in the presentation, treatment strategy, and outcomes of percutaneous coronary intervention (a report from the National Heart, Lung, and Blood Institute Dynamic Registry).
        Am J Cardiol. 2003; 92: 773-778
        • Yeo K.K.
        • Li Z.
        • Amsterdam E.
        Clinical characteristics and 30-day mortality among Caucasians, Hispanics, Asians, and African-Americans in the 2003 California coronary artery bypass graft surgery outcomes reporting program.
        Am J Cardiol. 2007; 100: 59-63
        • Minutello R.M.
        • Chou E.T.
        • Hong M.K.
        • Wong S.C.
        Impact of race and ethnicity on in hospital outcomes after percutaneous coronary intervention (report from the 2000–2001 New York State Angioplasty Registry).
        Am Heart J. 2006; 51: 164-167
        • Budoff M.J.
        • Nasir K.
        • Mao S.
        • Tseng P.H.
        • Chau A.
        • Liu S.T.
        • Flores F.
        • Blumenthal R.S.
        Ethnic differences of the presence and severity of coronary atherosclerosis.
        Atherosclerosis. 2006; 187: 343-350
        • Jacobi J.A.
        • Parikh S.V.
        • McGuire D.K.
        • Delemos J.A.
        • Murphy S.A.
        • Keeley E.C.
        Racial disparity in clinical outcomes following primary percutaneous coronary intervention for ST elevation myocardial infarction: influence of process of care.
        J Interv Cardiol. 2007; 20: 182-187
        • United States Census Bureau
        Hispanic population of the United States, 2008.
        (Accessed March 7, 2009)
        • Bourassa M.G.
        • Al-Bassam M.
        • Block P.C.
        • Coady P.
        • Cohen H.
        • Cowley M.
        • Dorros G.
        • Faxon D.
        • Holmes D.R.
        • Jacobs A.
        • Kelsey S.F.
        • King III, S.B.
        • Myler R.
        • Slater J.
        • Stanek V.
        • Vlachos H.A.
        • Detre K.M.
        Percutaneous coronary intervention in the current era compared with 1985–1986.
        Circulation. 2000; 102: 2945-2951
        • Hoffmann R.
        • Mintz G.S.
        Coronary in-stent restenosis—predictors, treatment and prevention.
        Eur Heart J. 2000; 21: 1739-1749
        • Kastrati A.
        • Schömig A.
        • Elezi S.
        • Schühlen H.
        • Dirschinger J.
        • Hadamitzky M.
        • Wehinger A.
        • Hausleiter J.
        • Walter H.
        • Neumann F.J.
        Predictive factors of restenosis after coronary stent placement.
        J Am Coll Cardiol. 1997; 30: 1428-1436
        • Cutlip D.E.
        • Chauhan M.S.
        • Baim D.S.
        • Ho K.K.
        • Popma J.J.
        • Carrozza J.P.
        • Cohen D.J.
        • Kuntz R.E.
        Clinical restenosis after coronary stenting: perspectives from multicenter clinical trials.
        J Am Coll Cardiol. 2002; 40: 2082-2089
        • Mercado N.
        • Boersma E.
        • Wijns W.
        • Gersh B.J.
        • Morillo C.A.
        • de Valk V.
        • van Es G.A.
        • Grobbee D.E.
        • Serruys P.W.
        Clinical and quantitative coronary angiographic predictors of coronary restenosis: a comparative analysis from the balloon-to-stent era.
        J Am Coll Cardiol. 2001; 38: 645-652
        • Carlisle D.M.
        • Leake B.D.
        • Shapiro M.F.
        Racial and ethnic differences in the use of invasive cardiac procedures among cardiac patients in Los Angeles County, 1986 through 1988.
        Am J Pub Health. 1995; 85: 352-356
        • Ford E.
        • Newman J.
        • Deosaransingh K.
        Racial and ethnic differences in the use of cardiovascular procedures: findings from the California Cooperative Cardiovascular Project.
        Am J Public Health. 2000; 90: 1128-1134
        • Giacomini M.K.
        Gender and ethnic differences in hospital-based procedure utilization in California.
        Arch Intern Med. 1996; 56: 1217-1224
        • Ramsey D.J.
        • Goff D.C.
        • Wear M.L.
        • Labarthe D.R.
        • Nichaman M.Z.
        Sex and ethnic differences in use of myocardial revascularization procedures in Mexican Americans and non-Hispanic whites: the Corpus Christi Heart Project.
        J Clin Epidemiol. 1997; 50: 603-609
        • DuBard C.A.
        • Gizlice Z.
        Language spoken and differences in health status, access to care, and receipt of preventive services among US Hispanics.
        Am J Public Health. 2008; 98: 2021-2028
        • Bild D.E.
        • Detrano R.
        • Peterson D.
        • Guerci A.
        • Liu K.
        • Shahar E.
        • Ouyang P.
        • Jackson S.
        • Saad M.F.
        Ethnic differences in coronary calcification: the Multi-Ethnic Study of Atherosclerosis (MESA).
        Circulation. 2005; 111: 1313-1320