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Effect of race and ethnicity on outcomes with drug-eluting and bare metal stents: results in 423 965 patients in the linked National Cardiovascular Data Registry and centers for Medicare & Medicaid services payer databases.

Publication ,  Journal Article
Kumar, RS; Douglas, PS; Peterson, ED; Anstrom, KJ; Dai, D; Brennan, JM; Hui, PYM; Booth, ME; Messenger, JC; Shaw, RE
Published in: Circulation
April 2, 2013

BACKGROUND: Black, Hispanic, and Asian patients have been underrepresented in percutaneous coronary intervention clinical trials; therefore, there are limited data available on outcomes for these race/ethnicity groups. METHODS AND RESULTS: We examined outcomes in 423 965 patients in the National Cardiovascular Data Registry CathPCI Registry database linked to Medicare claims for follow-up. Within each race/ethnicity group, we examined trends in drug-eluting stent (DES) use, 30-month outcomes, and relative outcomes of DES versus bare metal stents. Overall, 390 351 white, 20 191 black, 9342 Hispanic, and 4171 Asian patients > 65 years of age underwent stent implantation from 2004 through 2008 at 940 National Cardiovascular Data Registry participating sites. Trends in adoption of DES were similar across all groups. Relative to whites, black and Hispanic patients undergoing percutaneous coronary intervention had higher long-term risks of death and myocardial infarction (blacks: hazard ratio, 1.28; 95% confidence interval, 1.24-1.32; Hispanics: hazard ratio, 1.15; 95% confidence interval, 1.10-1.21). Long-term outcomes were similar in Asians and whites (hazard ratio, 0.99; 95% confidence interval, 0.92-1.08). Use of DES was associated with better 30-month survival and lower myocardial infarction rates compared with the use of bare metal stents among all race/ethnicity groups except Hispanics, who had similar outcomes with DES or bare metal stents. CONCLUSIONS: Black and Hispanic patients undergoing percutaneous coronary intervention had worse long-term outcomes relative to white and Asian patients. Compared with bare metal stent use, DES use was generally associated with superior long-term outcomes in all racial and ethnic groups, although these differences were not statistically significant in Hispanic patients.

Duke Scholars

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Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

April 2, 2013

Volume

127

Issue

13

Start / End Page

1395 / 1403

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Stents
  • Registries
  • Racial Groups
  • Medicare
  • Medicaid
  • Male
  • Longitudinal Studies
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Kumar, R. S., Douglas, P. S., Peterson, E. D., Anstrom, K. J., Dai, D., Brennan, J. M., … Shaw, R. E. (2013). Effect of race and ethnicity on outcomes with drug-eluting and bare metal stents: results in 423 965 patients in the linked National Cardiovascular Data Registry and centers for Medicare & Medicaid services payer databases. Circulation, 127(13), 1395–1403. https://doi.org/10.1161/CIRCULATIONAHA.113.001437
Kumar, Robert S., Pamela S. Douglas, Eric D. Peterson, Kevin J. Anstrom, David Dai, J Matthew Brennan, Peter Y. M. Hui, Michael E. Booth, John C. Messenger, and Richard E. Shaw. “Effect of race and ethnicity on outcomes with drug-eluting and bare metal stents: results in 423 965 patients in the linked National Cardiovascular Data Registry and centers for Medicare & Medicaid services payer databases.Circulation 127, no. 13 (April 2, 2013): 1395–1403. https://doi.org/10.1161/CIRCULATIONAHA.113.001437.
Kumar RS, Douglas PS, Peterson ED, Anstrom KJ, Dai D, Brennan JM, Hui PYM, Booth ME, Messenger JC, Shaw RE. Effect of race and ethnicity on outcomes with drug-eluting and bare metal stents: results in 423 965 patients in the linked National Cardiovascular Data Registry and centers for Medicare & Medicaid services payer databases. Circulation. 2013 Apr 2;127(13):1395–1403.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

April 2, 2013

Volume

127

Issue

13

Start / End Page

1395 / 1403

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Stents
  • Registries
  • Racial Groups
  • Medicare
  • Medicaid
  • Male
  • Longitudinal Studies
  • Humans