Kapoor Arjun B, Farhan Serdar, Vinayak Manish, Sartori Samantha, Feng Yihan, Prakash Yash, Mehran Roxana, Kini Annapoorna, Bhatt Deepak L, Sharma Samin K
Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
JACC Adv. 2025 May 13;4(6 Pt 1):101767. doi: 10.1016/j.jacadv.2025.101767.
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.
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.
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.
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).
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.
心血管疾病结局方面的种族和族裔差异，包括经皮冠状动脉介入治疗（PCI），已有充分记录。然而，研究并未对某些亚组进行分层，比如未将南亚和东亚患者区分开来，而这两个群体呈现出不同的心血管疾病负担和PCI结局。此外，社会经济地位（SES）使结局进一步复杂化，低SES是PCI术后不良结局的独立预测因素。
本研究旨在分析5个种族和族裔群体（白人、黑人、西班牙裔、南亚人和东亚人）的PCI结局，同时考虑合并症和SES，以更好地理解种族和族裔如何影响心血管结局。
我们对2012年至2022年接受PCI的患者进行了一项回顾性队列研究。患者按种族/族裔分层，并根据美国人口普查区改善计划代码数据与家庭收入中位数进行匹配。主要终点是1年主要不良心血管事件（MACE）。使用多变量Cox回归模型评估结局，并对合并症和SES进行调整。
共纳入21236例患者：47.8%为白人，11.3%为黑人，18.0%为西班牙裔，20.7%为南亚人，2.2%为东亚人。与白人患者相比，南亚患者的MACE显著更低（调整后HR：
0.62；P < 0.001）。相比之下，黑人患者发生MACE的风险更高（调整后HR：1.27；P = 0.032）。
1年PCI结局存在显著的种族和族裔差异，与白人患者相比，南亚患者结局良好，而黑人患者结局较差。基线合并症和估计的SES并不能完全解释这些差异，这表明需要针对性策略来应对种族和族裔群体中对PCI结局的多因素影响。
