Journal Article

Clinical Outcomes After Percutaneous Coronary Intervention for Left Main Coronary Artery Disease in Patients of Diverse Race/Ethnicity

Oliva, Angelo, Di Muro, Francesca Maria, Bay, Benjamin, Gitto, Mauro, Vogel, Birgit, Sartori, Samantha, Camaj, Anton, Sharma, Samin, Power, David, Smith, Kenneth, Dangas, George, Leone, Pier Pasquale, Roumeliotis, Anastasios, Mehran, Roxana, Murphy, Jonathan, Kini, Annapoorna

2025

Overview

Data on percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) disease in patients of diverse race/ethnicity are scant. This study aimed to assess the impact of race/ethnicity on clinical outcomes at 12-month follow-up of patients with LMCA disease who underwent PCI with drug-eluting stent implantation. All patients who underwent PCI for LMCA disease between 2010 and 2019 at a tertiary care center were prospectively enrolled. Clinical outcomes were assessed per each race/ethnic group. The primary end point was the composite of all-cause death, myocardial infarction, or stroke at 12 months. A total of 774 consecutive patients with known race/ethnicity were prospectively enrolled (62.1% [n = 481] Caucasian, 17.2% [n = 133] Hispanic, 12.7% [n = 98] Asian, and 8.0% [n = 62] African-American). Compared with Caucasians, the hazard rate of the primary end point tended to be lower in Asian patients (6.1% vs 14.2%; hazard ratio [HR] 0.41, 95% confidence interval [CI] 0.16 to 1.03) and similar in African-American (13.7% vs 14.2%; HR 0.93, 95% CI 0.40 to 2.16) and Hispanic patients (14.2% vs 14.2%; HR 1.02, 95% CI 0.58 to 1.78). Hazard rates of target vessel or lesion revascularization were comparable among the 4 groups. Cox multivariable regression adjustment confirmed consistent findings and revealed higher hazard rates of postdischarge bleeding in African-Americans compared with Caucasians (HR 5.89, 95% CI 1.00 to 34.5). In conclusion, within a racially/ethnically diverse cohort of patients who underwent PCI for LMCA disease, when compared with Caucasians, Asians had lower risk of all-cause death, myocardial infarction, or stroke, whereas African-Americans had increased risk of postdischarge bleeding.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: African Americans / Aged / Angioplasty / Asian / Asian people / Black or African American / Bleeding / Cardiovascular disease / Cause of Death - trends / Cerebral infarction / Clinical outcomes / Coronary artery disease / Coronary Artery Disease - ethnology / Coronary Artery Disease - surgery / Coronary vessels / Diabetes / Disease prevention / Drug delivery / drug-eluting stent / Drug-Eluting Stents / Electronic health records / Ethnicity / Female / Heart diseases / Hispanic or Latino / Hospitals / Humans / Implants / Intervention / left main / Male / Medical records / Middle Aged / Minority & ethnic groups / Myocardial infarction / Myocardial Infarction - epidemiology / Myocardial Infarction - ethnology / Older people / Patients / percutaneous coronary intervention / Percutaneous Coronary Intervention - methods / Prospective Studies / Race / Statistical analysis / Stroke / Stroke - epidemiology / Surgical implants / Tomography / Treatment Outcome / Ultrasonic imaging / Vein & artery diseases / White / White people