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Racial disparities in left main stenting: insights from a real world inner city population.

Abstract：

BACKGROUND:Left main coronary artery (LMCA) disease is associated with significant cardiovascular mortality. The data on patient characteristics' predicting outcomes after LMCA revascularization is sparse. METHODS:A retrospective study of 227 patients with LMCA disease documented on coronary angiography from March 2000 to December 2008. Data included demographic variables, co-morbidities, cardiac function, and medications. Race was self-identified. The study outcome was a composite end-point including myocardial infarction (MI) and all-cause mortality. Cox proportional hazard analysis was performed to study the effect of various patient attributes including race and gender on the composite end-point. RESULTS:Baseline characteristics were specifically compared between individuals who had the study outcome versus those who did not. Mean age was higher in the group with study outcomes when compared to the group without any outcomes (64.3 ± 11.8 years versus 59.2 ± 13.6 years; p = 0.013). After the final multivariate regression analysis, only African American (AA) race and age were found to be independent predictors of adverse cardiac outcome at the end of the first year (race-hazard ratio (HR) 3.82, 95% confidence interval (CI) 1.38-10.62, p = 0.010; age-HR 1.08, 95% CI 1.04-1.13, p < 0.001) and at the end of the study (race-HR 2.71, 95% CI 1.44-5.10, p = 0.002; age-HR 1.03, 95% CI 1.01-1.08, p = 0.017). CONCLUSION:In our study of patients with unprotected LMCA disease, AA race, and age were significantly predictive of poor prognosis following revascularization, while gender had no predictive value in prognosticating cardiovascular mortality.

journal_name

J Interv Cardiol

journal_title

Journal of interventional cardiology

authors

Mohamad T,Panaich SS,Alani A,Badheka A,Shenoy M,Mohamad B,Kanaan E,Ali O,Elder M,Schreiber TL

doi

10.1111/j.1540-8183.2013.12012.x

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

43-8

issue

1

eissn

0896-4327

issn

1540-8183

journal_volume

26

pub_type

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