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. 2024 May 20:43:100405.
doi: 10.1016/j.ahjo.2024.100405. eCollection 2024 Jul.

Gender, racial and ethnic disparities in acute coronary syndromes with coronary in-stent restenosis

Shivaraj Patil  1 , Chaitanya Rojulpote  2 , William Frick  2 , Abhijit Bhattaru  3 , Karanjit Sandhu  1 , Aditya Bakhshi  1 , Anum Shahzad  1 , Gregg Pressman  1 , Antonio Chamoun  1 , Div Verma  2 , Chien-Jung Lin  2
Affiliations

Gender, racial and ethnic disparities in acute coronary syndromes with coronary in-stent restenosis

Shivaraj Patil et al. Am Heart J Plus. .

Abstract

Background: Coronary in-stent restenosis (ISR) is a major clinical challenge of contemporary percutaneous revascularization and portends adverse cardiovascular outcomes.

Objectives: We aimed to evaluate gender, race, and ethnicity related outcomes in acute coronary syndromes (ACS) with ISR.

Methods: Primary hospitalizations for ACS and ISR in the National Inpatient Sample database from 2016 to 2019 were included. Patients were stratified by gender, race, and ethnicity. The primary end points were all cause in-hospital mortality and coronary revascularization defined as composite of percutaneous coronary intervention (PCI), balloon angioplasty and/or coronary artery bypass grafting (CABG).

Results: During the study period, a nationally weighted total of 97,680 patients with ACS and ISR were included. There was substantial variation in comorbidities, with greatest burden among Black and Hispanic women. All-cause in-hospital mortality was 2.4 % in the study cohort, but significantly higher in women (2.1 % vs. 2.1 %; aOR: 1.282, 95 % CI: 1.174-1.4; p < 0.001) and revascularization rates were significantly lower in women (77 % vs 80.2 %; aOR: 0.891, 95 % CI: 0.862-0.921; p < 0.001). Compared to White men, all women except Hispanic women, had significantly higher likelihood of in-hospital mortality, while White women, Black men and women, and Hispanic men had lower odds of revascularization.

Conclusions: There are significant gender, racial, and ethnic related differences in revascularization practices and clinical outcomes in patients with ACS and ISR with an adverse impact on women, racial and ethnic minorities in the U.S.

Keywords: Acute coronary syndrome; Disparities; Gender; In-stent restenosis; Race.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Adjusted Odds Ratio In-Hospital mortality highlighting increased odds of mortality in all women except Hispanic women as compared to men.
Fig. 2
Fig. 2
Adjusted Odds Ratio – Revascularization highlighting disparities in overall rates of revascularization as stratified by gender-race-ethnicity.
See this image and copyright information in PMC

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