Impact of gender and race on outcome following coronary angioplasty in a multiethnic population

Purpose: There is limited and conflicting data on the impacts of gender and race on patient (pts.) outcomes following coronary angioplasty (PTCA). Accordingly, we analyzed the clinical profiles and outcomes of PTCA in a multiethnic inner city population. Methods: Seven hundred and thirty three consecutive pts. were enrolled who were undergoing elective coronary angioplasty, using the catheterization laboratory data base. Pts. with acute myocardial infarction requiring primary PTCA were excluded form the study. The following variables were retrospectively analyzed: age, sex, race, hypertension (HTN) smoking, diabetes mellitus (DM), family history, peripheral vascular disease, history of prior PTCA / CABG, angioplasty vessel, left ventricular systolic function (LVEF) and acute procedural outcomes. Variables for acute procedural outcomes were angiographic success, cereberovascular accident (CVA), myocardial infarction (MI), CABG, death and others (i.e. arrhythmias, coronary dissections, abrupt closure, hematoma). Angiographic success was defined as residual stenosis less than 20%. Statistical analysis were performed using chi-square and t-test. Results: Four hundred and thirty one (58.8%) of 733 pts. were male and 302 (41.2%) female; 344 (47%) were White, 291 (40%) Black and 98 (13%) Hispanic. Female were older (63 vs 60 yrs; p<.003), more often had DM (38.7% vs 25.8%; p<.002), HTN (76.5% vs 62.6%; p<.001), functional class IV (35.8% vs 25.3%; p<.004) and were less often smokers (31.1% vs 58%, p<.001) than males. There were no differences for indications for PTCA, number of diseased vessels, LVEF, procedural success or complications. Whites were older (64 vs 59 and 49 yrs; p<.05) and more often smokers (53% vs 39% and 49%; p<.002) than Blacks and Hispanics. Hispanics more often had peripheral vascular disease (6.1% vs 2 7% and 15%; p<.03) than Blacks and Whites. Blacks and Hispanics more often had DM (38.8% and 38.8% vs 22.4%; p<.001), HTN (76% and 70% vs 61.1%; p<.007) and no. of diseased vessels (1.62 and 1.67 vs 1.50; p=0.01) than Whites. There were no ethnic differences for indications for procedure, LVEF, procedural success, or overall complications. Conclusions: In this multiethnic population, although there are gender and race differences in coronary risk profile, there were no differences in acute procedural outcomes. Clinical Implications: Gender and race should not influence the revascularization strategy in pts. with CAD.