Abstract 105: Racial Differences in Health Status, Clinical Characteristics and Treatment Patterns Among Patients With Peripheral Artery Disease: Insights From the PORTRAIT Registry

Abstract

Background: Despite the higher prevalence and excess morbidity associated with peripheral arterial disease (PAD) in blacks, as compared with whites, little is known about racial differences in clinical characteristics, treatment referral and health status outcomes (symptoms, functioning, quality of life) at the time of PAD presentation. Methods: We used data from the Patient-centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease Investigating Trajectories (PORTRAIT) registry, a multicenter, international prospective study of patients with new or worsening PAD symptoms consulting specialty care (2011-2015). Clinical and treatment characteristics were abstracted from medical records and health status was collected via patient interviews at presentation using the Peripheral Artery Questionnaire (PAQ). We calculated summary statistics using t-test/chi-square analyses and examined mean differences in the PAQ summary score at baseline between blacks and whites. Results: The final cohort consisted of 760 patients (N=183 blacks; 24%). Compared with whites, blacks were younger (66±9.8 vs 70±9.2; P=< 0.001), more likely to be female (58% vs. 37%, P= <0.001), non-married (40% vs. 59% P=<0.001), and had a higher prevalence of hypertension (94.5% vs. 86.3%, P=0.002), diabetes (47.5% vs. 34.8%, P= 0.002), chronic kidney disease (23.5% vs. 12.7%, P=<0.001), current smoking (38.8% vs. 25.5%, P=0.002) and lower ankle brachial index values (0.6 vs. 0.7, P=0.034). Blacks were also less likely to have had prior percutaneous coronary intervention (22.4% vs. 29.3%, P= 0.07) or coronary artery bypass grafting (13.7% vs. 28.4%, P=< 0.001), but had similar rates of non-healing ulcers (2.2% vs. 1.4%, P=0.50) or amputation (2.7% vs. 1.0%, P=0.146). Black and white patients had similar mean PAQ summary scores at presentation (46.8±22.4 vs. 47.6±21.8; P=0.669) and were equally likely to be referred for revascularization (30.1% vs. 36.9 %, P=0.09) Conclusion: Despite excess prevalence of adverse risk factors including diabetes, hypertension, and smoking, black patients presenting with PAD have similar health status outcomes and invasive treatment strategies when compared with whites. Follow-up studies are needed to determine if these observations persist after adjustment for covariates and if there are differences in health status recovery over time.