Abstract
Background: Although Asians and Pacific Islanders (PI) make up the fastest growing ethnic group in the United States, little is known about the clinical characteristics, procedural success, and procedure‐related complications of those who undergo percutaneous coronary interventions (PCI).
Hypothesis: This study investigated PCI procedural success and procedural complications among PI and Asian patients in comparison with Caucasians.
Methods: We examined clinical characteristics, procedural success (post‐PCI lesion < 50%) and procedure‐related complications (hemorrhage, renal failure, myocardial infarction, stroke, bypass surgery, death) for all patients undergoing PCI at our hospital from January 1999 to June 2003.
Results: Overall, 2,598 PCIs were performed—1,058 (39%) in Caucasians, 1,163 (43%) in Asians, and 377 (14%) in PIs. The mean age of PIs (59 ± 11 years) was significantly lowerthan that of Caucasians (65 ± 12 years) and Asians (66 ± 12 years). The mean body mass index (26 ± 5) of Asians was significantly lower, while that of PIs (31 ± 7) was significantly higher than that of Caucasians (28 ± 6). More Asians (33.3%) and PIs (40.5%) had diabetes mellitus than did Caucasians (19.9%). More Asians (71.6%) and PIs (76.1%) had hypertension than did Caucasians (61.9%). Renal failure was more prevalent in Asians and PIs (6.0 and 7.4%, respectively) than in Caucasians (3.8%). Other than a higher prevalence of disease involving the left anterior descending vessel in Asians (56.4%) compared with Caucasians (50.4%), angiographic features across the three races were similar. There was no significant difference in procedural success (∼ 94%) or procedure‐related complications among Caucasians (6.4%), Asians (7.1%), and PIs (4.3%).
Conclusion: Although PIs and Asians have a substantially higher burden of comorbidities than Caucasians, race does not appear to influence PCI procedural success or procedure‐related complications.
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References
- 1. American Heart Association. Heart Disease and Stroke Statistics—2004 Update. Dallas, Tex.: American Heart Association, 2003. [Google Scholar]
- 2. Slater J, Selzer F, Dorbala S, Tormey D, Vlachos HA, Wilensky RL, Jacobs AK, Laskey WK, Douglas JS Jr, Williams DO, Kelsey SF: Ethnic differences in the presentation, treatment strategy, and outcomes of percutaneous coronary intervention (a report from the National Heart, Lung, and Blood Institute Dynamic Registry). Am J Cardiol 2003; 92: 773–778 [DOI] [PubMed] [Google Scholar]
- 3. Rathore SS, Krumholz HM: Race, ethnic group, and clinical research. Br Med J 2003; 327: 763–764 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4. Office of Prevention, Education, and Control. National Heart, Lung, and Blood Institute: Addressing cardiovascular health in Asian Americans and Pacific Islanders. NIH Publication No. 00‐3647; January 2000.
- 5. Chung CS, Tash E, Raymond J, Yasunobu C, Lew R: Health risk behaviours and ethnicity in Hawaii. Int J Epidemiol 1990; 19: 1011–1018 [DOI] [PubMed] [Google Scholar]
- 6. Hawaii Health Survey 2003. Hawaii State Department of Health. Honolulu, Hawaii 2004. Available from: http://www.hawaii.gov/health/statistics/hhs/hhs_03/index.html. Accessed 27 Sep 2004.
- 7. Hawaii's Health Risk Behaviors, 1990–1993. Hawaii State Department of Health, Health Promotion and Education Branch, Honolulu, Hawaii, 1995. [Google Scholar]
- 8. Scott NA, Kelsey SF, Detre K, Cowley M, King SB III: Percutaneous transluminal coronary angioplasty in African‐American patients (the National Heart, Lung, and Blood Institute 1985–1986 Percutaneous Transluminal Coronary Angioplasty Registry). Am J Cardiol 1994; 73: 1141–1146 [DOI] [PubMed] [Google Scholar]
- 9. Marks DS, Mensah GA, Kennard ED, Detre K, Holmes DR Jr: Race, baseline characteristics, and clinical outcomes after coronary intervention: The New Approaches in Coronary Interventions (NACI) registry. Am Heart J 2000; 140: 162–169 [DOI] [PubMed] [Google Scholar]
- 10. Mastoor M, Iqbal U, Pinnow E, Lindsay J Jr: Ethnicity does not affect outcomes of coronary angioplasty. Clin Cardiol 2000; 23: 379–382 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11. Maynard C, Wright SM, Every NR, Ritchie JL: Racial differences in outcomes of veterans undergoing percutaneous coronary interventions. Am Heart J 2001; 142: 309–313 [DOI] [PubMed] [Google Scholar]
- 12. Iqbal U, Pinnow EE, Lindsay J Jr: Comparison of six‐month outcomes after percutaneous coronary intervention for Whites versus African‐Americans. Am J Cardiol 2001; 88: 304–305 [DOI] [PubMed] [Google Scholar]
- 13. Garg M, Vacek JL, Hallas D: Coronary angioplasty in black and white patients: Demographic characteristics and outcomes. South Med J 2000; 93: 1187–1191 [PubMed] [Google Scholar]
- 14. Trevelyan J, Needham EWA, Halim M, Singh H, Been M, Shiu MF, Mattu RK: Evaluation of patient characteristics and utilization of invasive cardiac procedures in a UK ethnic population with unstable angina pectoris. Int J Cardiol 2001; 77: 275–280 [DOI] [PubMed] [Google Scholar]
- 15. Carlisle DM, Leake BD, Shapiro MF: Racial and ethnic differences in the use of invasive cardiac procedures among cardiac patients in Los Angeles County, 1986 through 1988. Am J Pub Health 1995; 85: 352–356 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16. U. S Census Bureau. Census 2000 Summary File. Available from http://factfinder.census.gov/. Accessed 30 May 2004.