Percutaneous transluminal coronary angioplasty in African-American patients (The National Heart, Lung, and Blood Institute 1985–1986 Percutaneous Transluminal Coronary Angioplasty Registry)

Abstract

Although black patients have a higher prevalence of risk factors for coronary artery disease, the outcome of coronary angioplasty in black patients is not known. The purpose of this study was to determine if any racial differences existed in the clinical characteristics and outcome of patients enrolled in the 1985–1986 National Heart, Lung, and Blood Institute (NHLBI) Percutaneous Transluminal Coronary Angioplasty (PTCA) Registry. The clinical characteristics, in-hospital event rates, and 5-year follow-up results of all patients enrolled in the 1985–1986 NHLBI PTCA Registry were examined with respect to race. Of the patients enrolled in the registry, 1,939 (90.8%) were white and 76 (3.6%) were black. Among black patients there were more women (50% vs 24%, p < 0.001), and more patients who had hypertension (73% vs 45%, p < 0.001) and diabetes (23% vs 13%, p < 0.05). Black patients were more likely to have multivessel disease (72% vs 48%, p < 0.001). Clinical success rates were similar (76.3% for blacks and 79.3% for whites), but because black patients had more vessels with significant disease, complete revascularization was achieved in 26% of black patients compared with 44% of white patients (p < 0.001). After the PTCA procedure there was no significant difference in major complications (death, myocardial infarction, or emergent coronary artery bypass grafting) between the 2 groups. Five-year follow-up data revealed that there was no significant difference in mortality, myocardial infarction, coronary artery bypass grafting, or repeat PTCA. Black patients in the NHLBI PTCA Registry had a similar incidence of acute and long-term events when compared with white patients despite the presence of more cardiovascular risk factors, symptoms, and multivessel disease.