Abstract 12544: Sex Differences in Cardiac Catheterization Outcomes Among Black Patients in an Urban Center

Abstract

Introduction: Sex disparities persist in the management of CAD. Although between-racial and ethnic group disparities continue to exist, there are limited data regarding intra-race sex differences within African American (AA) populations. Thus, we describe the sex differences in outcomes among Black patients receiving left heart catheterization (LHC) in a large urban medical center (UMC). Methods: Using electronic health data, we extracted data of AA patients (pts) undergoing LHC between January 2014 to December 2019 from an UMC. Baseline demographics and management were compared between men and women. The primary outcome of interest was percutaneous coronary intervention (PCI), with secondary outcomes of coronary artery bypass graft (CABG) and Intra-aortic balloon pump (IABP). Outcomes were analyzed with chi-square testing and multivariable regression. Results: There were 3,379 LHC performed (42% in women). Men were relatively younger compared to women (63±11 vs 65±12, p<0.001), had lower BMI (29±8 vs 33±9, p<0.001), EF (45±15 vs 50±15, p<0.001), and rates of health insurance (59% vs 66%, p<0.001). Women had higher rates of dyslipidemia (42% vs 33%, p<0.001), hypertension (87% vs 83%, p=0.001), and Type II DM (43.6% vs 33.6%, p<0.001), but lower rates of smoking (30.5% vs 45%, p<0.001). Men also had higher rates of STEMI 12.8% vs 5.2% and NSTEMI 29.6% vs 28.7% (P<0.001). Men were more likely to receive PCI (40.5% vs 34.5%, p<0.001), CABG (4.6% vs 2.3%, p=0.001), and IABP (2.1% vs 0.5%, p=0.001). After multivariable regression, men had higher odds of PCI (OR=1.15, p=0.15), CABG (OR=2.4, p=0.001), and IABP (OR=5.5, p=0.002). Conclusions: In this cohort of AA pts receiving LHC at an urban center, men were more likely to undergo interventions including PCI, CABG, and IABP as compared to women. Even among AA populations, significant sex differences occur. More work is needed to understand underlying factors and address healthcare disparities in this high-risk population.