African Americans Experience Worse Long-Term Outcomes After PCI
May 6, 2011 – African American patients who undergo angioplasty and stenting fare worse over the long run than patients of other races, regardless of socioeconomic status. In fact, the risk of dying within about three years is more than twice as high among African Americans, according to a study presented today at the Society for Cardiovascular Angiography and Interventions (SCAI) 2011 Scientific Sessions.
“We need to channel healthcare resources to effectively treat this vulnerable population,” said Steve Attanasio, D.O., an interventional cardiology fellow at Rush University Medical Center in Chicago. “It’s very worrisome that the first major cardiac problem many of these patients experience following coronary intervention is death.”
The study focused on 1,432 consecutive patients who had percutaneous coronary intervention (PCI) at John H. Stroger, Jr. Hospital of Cook County in Chicago and received follow-up within the same public health system. The patients were relatively young (57-years-old on average). They were also relatively high-risk: Only about 30 percent had a pre-scheduled procedure for stable coronary disease, while the remaining 70 percent needed urgent PCI because of a heart attack or unstable chest pain.
After an average follow-up of 2.7 years, the combined rate of survival without heart attack or need for a repeat procedure in the treated artery was 78 percent among African American patients, as compared with 86 percent among patients of another race (p=0.001). The overall death rate at 2.7 years was 8.6 percent; however, among African Americans, it spiked to 12.1 percent, as compared with 5 percent among other patients (p<0.005). Health outcomes were independent of socioeconomic status, investigators found.
The reason for the increased risk among African Americans is not yet known, though many things may play a role, including poorly understood genetic and sociocultural factors. But the importance of aggressively treating risk factors such as diabetes, high blood pressure, high cholesterol and smoking is clear, as is the need to educate patients about a heart-healthy lifestyle.
“The ultimate goal is prevention,” Attanasio said. “We need to reach out not only to patients but also to healthcare providers. It’s not enough to perform a stenting procedure. These patients require close follow-up.”
This study received no outside funding.
For more information: www.scai.org, www.SecondsCount.org