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Review
. 2023 Jul 25;15(7):e42457.
doi: 10.7759/cureus.42457. eCollection 2023 Jul.

Racial Disparities and Outcomes of Percutaneous Coronary Interventions in Patients Above 65 Years in America: A Systematic Review

Olawale O Olanisa  1 , Panah Parab  1 , Priti Chaudhary  1 , Sonia Mukhtar  1   2 , Ali Moradi  1 , Athri Kodali  1 , Chiugo Okoye  1 , Dhadon Klein  1 , Iman Mohamoud  1 , Lubna Mohammed  1
Affiliations
Review

Racial Disparities and Outcomes of Percutaneous Coronary Interventions in Patients Above 65 Years in America: A Systematic Review

Olawale O Olanisa et al. Cureus. .

Abstract

This systematic review aims to examine the racial disparities and outcomes of percutaneous coronary interventions (PCIs) in patients above 65 years in America. The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines 2020 and includes a comprehensive search strategy, study selection, data extraction, and quality assessment. The search strategy identified 10 relevant articles that were included in the review. The findings indicate that racial disparities exist in access to PCI, door-to-balloon (DTB) time, procedure utilization, and outcomes among elderly patients. African American and Hispanic patients were found to experience longer door-to-balloon time and lower rates of PCI utilization compared to White patients. Moreover, racial and ethnic minorities had worse clinical outcomes, including higher mortality rates and increased risk of major adverse cardiovascular events. The review also highlights the impact of Medicaid expansion on reducing disparities in access, treatment, and outcomes for patients with acute myocardial infarction (AMI). However, limitations in data availability and representation of racial and ethnic minorities in clinical trials were identified. The discussion section provides a robust analysis of the findings, exploring potential underlying factors contributing to the observed disparities. The review concludes that addressing racial disparities in PCI outcomes among elderly patients is crucial for achieving equitable healthcare delivery and improving cardiovascular health outcomes in America.

Keywords: acute mi; bare-metal stents (bms); coronary artery disease (cad); door-to-balloon time; drug-eluting stents (des); end-stage renal disease (esrd); percutaneous coronary intervention (pci); st-segment elevation myocardial infarction (stemi).

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flowchart: an overview of the screening procedure
AMSTAR 2: Assessment of Multiple Systematic Reviews 2, SANRA: Scale for the Quality Assessment of Narrative Review Articles, JBI Critical Appraisal Checklist: Joanna Briggs Institute Critical Appraisal Checklist, PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analysis
See this image and copyright information in PMC

References

    1. Comparison of long-term safety and efficacy outcomes after drug-eluting and bare-metal stent use across racial groups: insights from NHLBI Dynamic Registry. Olafiranye O, Vlachos H, Mulukutla SR, et al. Int J Cardiol. 2015;184:79–85. - PMC - PubMed
    1. Relationship of race/ethnicity with door-to-balloon time and mortality in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction: findings from Get With the Guidelines-Coronary Artery Disease. Cavender MA, Rassi AN, Fonarow GC, et al. Clin Cardiol. 2013;36:749–756. - PMC - PubMed
    1. Trends in and disparities for acute myocardial infarction: an analysis of Medicare claims data from 1992 to 2010. Singh JA, Lu X, Ibrahim S, Cram P. BMC Med. 2014;12:190. - PMC - PubMed
    1. The association of Medicaid expansion and racial/ethnic inequities in access, treatment, and outcomes for patients with acute myocardial infarction. Valdovinos EM, Niedzwiecki MJ, Guo J, Hsia RY. PLoS One. 2020;15:0. - PMC - PubMed
    1. Risk of major adverse cardiovascular events and major hemorrhage among white and black patients undergoing percutaneous coronary intervention. Anping Cai, Chrisly Dillon, William B. Hillegass, et al. J Am Heart Assoc. 201919;8:12874–12019. - PMC - PubMed

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