Percutaneous Coronary Intervention Outcomes by 5 Major Race and Ethnic Subgroups

Background: Racial and ethnic disparities in cardiovascular disease outcomes, including percutaneous coronary intervention (PCI), are well-documented. However, studies do not stratify certain subgroups, such as separating South Asian and East Asian patients, who exhibit varying burdens of cardiovasc...

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Main Authors: Arjun B. Kapoor, MD, Serdar Farhan, MD, Manish Vinayak, MD, Samantha Sartori, PhD, Yihan Feng, MS, Yash Prakash, MD, Roxana Mehran, MD, Annapoorna Kini, MD, Deepak L. Bhatt, MD, MPH, MBA, Samin K. Sharma, MD
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:JACC: Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772963X2500184X
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author Arjun B. Kapoor, MD
Serdar Farhan, MD
Manish Vinayak, MD
Samantha Sartori, PhD
Yihan Feng, MS
Yash Prakash, MD
Roxana Mehran, MD
Annapoorna Kini, MD
Deepak L. Bhatt, MD, MPH, MBA
Samin K. Sharma, MD
author_facet Arjun B. Kapoor, MD
Serdar Farhan, MD
Manish Vinayak, MD
Samantha Sartori, PhD
Yihan Feng, MS
Yash Prakash, MD
Roxana Mehran, MD
Annapoorna Kini, MD
Deepak L. Bhatt, MD, MPH, MBA
Samin K. Sharma, MD
author_sort Arjun B. Kapoor, MD
collection DOAJ
description Background: Racial and ethnic disparities in cardiovascular disease outcomes, including percutaneous coronary intervention (PCI), are well-documented. However, studies do not stratify certain subgroups, such as separating South Asian and East Asian patients, who exhibit varying burdens of cardiovascular disease and PCI outcomes. Additionally, socioeconomic status (SES) further complicates outcomes, with low SES serving as an independent predictor of adverse outcomes post-PCI. Objectives: This study aimed to analyze PCI outcomes across 5 racial and ethnic groups—White, Black, Hispanic, South Asian, and East Asian populations—while accounting for comorbidities and SES to better understand how race and ethnicity influence cardiovascular outcomes. Methods: We conducted a retrospective cohort study of patients undergoing PCI from 2012 to 2022. Patients were stratified by race/ethnicity and matched to median household income based on U.S. Census Zone Improvement Plan code data. The primary endpoint was 1-year major adverse cardiovascular events (MACE). Multivariable Cox regression models were used to assess outcomes, adjusting for comorbidities and SES. Results: A total of 21,236 patients were included: 47.8% White, 11.3% Black, 18.0% Hispanic, 20.7% South Asian, and 2.2% East Asian. South Asian patients had significantly lower MACE (adjusted HR: 0.62; P < 0.001) compared with White patients. Black patients, in contrast, had a higher risk of MACE (adjusted HR: 1.27; P = 0.032). Conclusions: Significant racial and ethnic disparities exist in 1-year PCI outcomes, with South Asian patients exhibiting favorable outcomes compared with White patients, and Black patients experiencing worse outcomes. Baseline comorbidities and estimated SES do not fully explain these disparities, suggesting that targeted strategies are needed to address the multifactorial influences on PCI outcomes across racial and ethnic groups.
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spelling doaj-art-dbe2bd2cc9294b13901fb822c2b8d3b22025-08-20T03:49:42ZengElsevierJACC: Advances2772-963X2025-06-014610176710.1016/j.jacadv.2025.101767Percutaneous Coronary Intervention Outcomes by 5 Major Race and Ethnic SubgroupsArjun B. Kapoor, MD0Serdar Farhan, MD1Manish Vinayak, MD2Samantha Sartori, PhD3Yihan Feng, MS4Yash Prakash, MD5Roxana Mehran, MD6Annapoorna Kini, MD7Deepak L. Bhatt, MD, MPH, MBA8Samin K. Sharma, MD9Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USAZena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USAZena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USAZena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USAZena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USADepartment of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USAZena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USAZena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USAMount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, New York, USAZena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Address for correspondence: Dr Samin K. Sharma, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, New York 10029-6574, USA.Background: Racial and ethnic disparities in cardiovascular disease outcomes, including percutaneous coronary intervention (PCI), are well-documented. However, studies do not stratify certain subgroups, such as separating South Asian and East Asian patients, who exhibit varying burdens of cardiovascular disease and PCI outcomes. Additionally, socioeconomic status (SES) further complicates outcomes, with low SES serving as an independent predictor of adverse outcomes post-PCI. Objectives: This study aimed to analyze PCI outcomes across 5 racial and ethnic groups—White, Black, Hispanic, South Asian, and East Asian populations—while accounting for comorbidities and SES to better understand how race and ethnicity influence cardiovascular outcomes. Methods: We conducted a retrospective cohort study of patients undergoing PCI from 2012 to 2022. Patients were stratified by race/ethnicity and matched to median household income based on U.S. Census Zone Improvement Plan code data. The primary endpoint was 1-year major adverse cardiovascular events (MACE). Multivariable Cox regression models were used to assess outcomes, adjusting for comorbidities and SES. Results: A total of 21,236 patients were included: 47.8% White, 11.3% Black, 18.0% Hispanic, 20.7% South Asian, and 2.2% East Asian. South Asian patients had significantly lower MACE (adjusted HR: 0.62; P < 0.001) compared with White patients. Black patients, in contrast, had a higher risk of MACE (adjusted HR: 1.27; P = 0.032). Conclusions: Significant racial and ethnic disparities exist in 1-year PCI outcomes, with South Asian patients exhibiting favorable outcomes compared with White patients, and Black patients experiencing worse outcomes. Baseline comorbidities and estimated SES do not fully explain these disparities, suggesting that targeted strategies are needed to address the multifactorial influences on PCI outcomes across racial and ethnic groups.http://www.sciencedirect.com/science/article/pii/S2772963X2500184XethnicityoutcomesPCIrace
spellingShingle Arjun B. Kapoor, MD
Serdar Farhan, MD
Manish Vinayak, MD
Samantha Sartori, PhD
Yihan Feng, MS
Yash Prakash, MD
Roxana Mehran, MD
Annapoorna Kini, MD
Deepak L. Bhatt, MD, MPH, MBA
Samin K. Sharma, MD
Percutaneous Coronary Intervention Outcomes by 5 Major Race and Ethnic Subgroups
JACC: Advances
ethnicity
outcomes
PCI
race
title Percutaneous Coronary Intervention Outcomes by 5 Major Race and Ethnic Subgroups
title_full Percutaneous Coronary Intervention Outcomes by 5 Major Race and Ethnic Subgroups
title_fullStr Percutaneous Coronary Intervention Outcomes by 5 Major Race and Ethnic Subgroups
title_full_unstemmed Percutaneous Coronary Intervention Outcomes by 5 Major Race and Ethnic Subgroups
title_short Percutaneous Coronary Intervention Outcomes by 5 Major Race and Ethnic Subgroups
title_sort percutaneous coronary intervention outcomes by 5 major race and ethnic subgroups
topic ethnicity
outcomes
PCI
race
url http://www.sciencedirect.com/science/article/pii/S2772963X2500184X
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