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Drug Eluting Stents (DES) decrease in stent re-stenosis by about 80% when compared to Bare Metal Stents (BMS). Racial disparities have been reported in the use of cardiovascular procedures. We explore such disparities in Florida.
We conducted a cross-sectional analysis of all stent procedures between 2006-09. Then calculated the yearly usage of stents, and determined the odds ratio (OR) of having a DES by race/ethnicity adjusting for Charlson score, insurance, and year. A subgroup analysis was also conducted for diabetics.
There were 188,260 coronary stent recipients; mostly White (158,039) followed by Hispanics (16,087) and Blacks (14,037). Blacks had the highest comorbidity scores (p<0.01). The use of DES decreased from 2006-09 in all ethnicities. The OR of having a DES for Blacks was 0.84, 95% CI 0.81-0.88 (p<0.01); and for Hispanics was 1.24, 95% CI 1.19-1.29 (p<0.01) when compared to Whites. There were 62,798 diabetic patients, 78% Whites followed by Blacks and Hispanics (11% respectively). The OR of having a DES for diabetic Blacks was 0.93, 95% CI 0.88-0.99 (p=0.02); and for Hispanics was 1.34, 95% CI 1.25-1.43 (p<0.01).
From 2006-09, Blacks received less DES while Hispanics received more when compared to Whites with the same insurance and comorbidity burden, with similar findings in diabetics. The roles that local majority-minorities and race concordance have on stent selection and perceptions of adherence to antiplatelet medications need to be explored.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Disparities and Cardiovascular Epidemiology
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1244-98
- 2013 American College of Cardiology Foundation