Document Detail


Association of a unique cardiovascular risk profile with outcomes in Hispanic patients referred for percutaneous coronary intervention (from the National Heart, Lung, and Blood Institute Dynamic Registry).
MedLine Citation:
PMID:  19733710     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although previous studies have demonstrated that Hispanic patients have a higher cardiovascular risk profile than Caucasians and present at a younger age for percutaneous coronary intervention (PCI), limited studies exist examining the outcomes of Hispanics after PCI and potential explanations for differences noted. Using patients from the National Heart, Lung, and Blood Institute Dynamic Registry waves 1 to 5 (1997 to 2006), demographic features, angiographic data, and 1-year outcomes of Hispanic patients (n = 542) versus Caucasian patients (n = 1,357) undergoing PCI were evaluated. Compared to Caucasians, Hispanic patients were younger and had more hypertension and diabetes mellitus, including more insulin-treated diabetes mellitus. Although mean lesion length was longer in Hispanics (15.4 vs 14.1 mm, p <0.001), there were no differences in the number of significant lesions or in the use of drug-eluting stents. At follow-up, Hispanics were more likely to report recent anginal symptoms but had a similar incidence of 1-year hospitalizations for angina. Adjusted 1-year hazard ratios for adverse events for Hispanics versus Caucasians revealed lower rates of coronary artery bypass graft surgery (hazard ratio 0.43, confidence interval 0.22 to 0.85, p = 0.02) and a trend toward lower rates of repeat revascularization (hazard ratio 0.76, confidence interval 0.57 to 1.03, p = 0.08). In conclusion, despite the presence of diabetes in almost 50% of Hispanic patients and longer lesions than in Caucasians, Hispanic patients were less likely to undergo coronary artery bypass graft surgery 1 year after PCI and had a trend toward lower rates of repeat revascularization.
Authors:
Shailja V Parikh; Jonathan R Enriquez; Faith Selzer; James N Slater; Warren K Laskey; Robert L Wilensky; Oscar C Marroquin; Elizabeth M Holper
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2009-07-25
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-07     Completed Date:  2009-09-25     Revised Date:  2010-09-27    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  775-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern, Dallas, Texas, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / mortality,  statistics & numerical data*
Coronary Artery Bypass / mortality,  statistics & numerical data
Diabetic Angiopathies / ethnology,  mortality,  therapy
Drug-Eluting Stents / statistics & numerical data
Female
Health Services Accessibility
Hispanic Americans*
Hospitalization / statistics & numerical data
Humans
Male
Middle Aged
Myocardial Ischemia / ethnology*,  mortality,  surgery,  therapy*
Outcome Assessment (Health Care)
Proportional Hazards Models
Registries
Retreatment / statistics & numerical data
Risk Factors
United States / epidemiology
Grant Support
ID/Acronym/Agency:
HL-33292/HL/NHLBI NIH HHS; U01 HL033292-15/HL/NHLBI NIH HHS; U01 HL033292-16/HL/NHLBI NIH HHS; U01 HL033292-17/HL/NHLBI NIH HHS; U01 HL033292-18/HL/NHLBI NIH HHS; U01 HL033292-19/HL/NHLBI NIH HHS; U01 HL033292-20/HL/NHLBI NIH HHS; U01 HL033292-21/HL/NHLBI NIH HHS; U01 HL033292-22/HL/NHLBI NIH HHS; U01 HL033292-23/HL/NHLBI NIH HHS
Comments/Corrections

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