Author + information
- Lonnie T. Sullivana,b,
- Hillary Muldera,b,
- Karen Chiswella,b,
- Linda Shawa,b,
- Tracy Wanga,b and
- Kevin Thomasa,b
Background: Rates of major adverse cardiac events after percutaneous coronary intervention (PCI) with drug eluting stent (DES) placement vary by race. This may in part be explained by dual antiplatelet therapy (DAPT) utilization over time.
Methods: We analyzed 915 black and 3,559 white patients who underwent DES placement at Duke University Medical Center from 2005 through 2013. DAPT use at hospital discharge and at 6, 12, 24, and 36-month follow-up was compared by race. Logistic regression was used to model the effects of race on DAPT use at discharge by year. DAPT use and clinical outcomes post-PCI were compared between cohorts.
Results: Black patients were younger, had more diabetes, hypertension, and renal disease than white patients. At discharge, there were no significant racial differences in the utilization of DAPT (p=0.158). DAPT use decreased longitudinally following initial PCI, but did not differ significantly by race. From 2005–2013, DAPT use at hospital discharge increased by year of PCI, from 86.3% in 2005 to 96.7% in 2013 (p<0.001), without significant racial variation (Figure 1). Black patients had higher observed rates of death (6.9% vs. 4.7%, p<0.01) and MI or death (10.4% vs. 7.4%, p<0.01), but similar rates of revascularization (11.5% vs. 10.6%, p=0.46) and nonfatal MI (4.0% vs. 3.1%, p=0.15) relative to white patients at 12 months.
Conclusions: Black DES recipients had worse cardiovascular outcomes than white patients despite similar rates of DAPT utilization through 1-year post-PCI.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Considerations in Antiplatelet Therapy and in ACS
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1113-137
- 2017 American College of Cardiology Foundation