The following is the summary of “Race and outcomes after percutaneous coronary intervention: Insights from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium” published in the January 2023 issue of Heart Journal by spehar, et al.

Recent research has shown that after undergoing percutaneous coronary intervention (PCI), Black and White patients have similar in-hospital outcomes. Less is known about the longer-term results and the part played by individual and community-level socioeconomic factors in differential risk. Researchers matched data from 48 hospitals in Michigan’s clinical registries documenting percutaneous coronary interventions (PCIs) conducted between January, 2013, and March, 2018, to Medicare Fee-for-service claims. Differentiating between Black and White patients was a major focus of their research. 

For the purpose of estimating the likelihood of a readmission within 90 days after discharge, investigators utilized propensity score matching and logistic regression models, while for the purpose of assessing the risk of postdischarge mortality, they used Cox regression. Through the use of mediation analysis, they calculated the extent to which socioeconomic characteristics mediated the original link. The research included 29,317 patients, 10.28% of whom were Black and 89.72% of whom were White. In-hospital outcomes following percutaneous coronary intervention were similar across groups. Adjusting for age and gender, Black patients had a significantly greater risk of all-cause death (adjusted HR 1.45, 95% CI 1.30-1.61) and readmission within 90 days after discharge (adjusted OR 1.62, 95% CI [1.32-2.00]). 

The proportion mediated (PM) for readmission was 11% and for mortality it was 21%; for readmission and community economic well-being, the PM was 23% and for mortality it was 43%; and for readmission, community economic well-being, and baseline clinical characteristics, the PM was 45% and for mortality it was 87.8%. After PCI, Black patients had a greater risk of readmission within 90 days and cumulative mortality than White patients did. Traditional cardiovascular risk factors such as poverty and unemployment rates, as well as dual eligibility, moderated the associations. Their research suggests that one method to reduce health care inequalities associated with cardiovascular disease would be to streamline the pathways by which patients receive care after they have been discharged from the hospital.

Source: sciencedirect.com/science/article/abs/pii/S000287032200196X