Racial differences in outcomes of veterans undergoing percutaneous coronary interventions.

BACKGROUND: In the era of stenting relatively little is known about racial differences in the outcomes of percutaneous interventions (PCI). The purpose of this study was to determine whether there were racial differences with respect to short- and long-term outcomes in veterans undergoing PCI.

METHODS: We used the national Department of Veterans Affairs (VA) patient treatment file to identify 24,625 African American and white veterans who had PCI in VA medical centers between October 1, 1994, and September 30, 1999. Baseline demographic characteristics were obtained, as was a measure of comorbidity. Short-term outcomes included hospital mortality and same-admission coronary artery bypass surgery, and long-term outcomes were vital status and rehospitalization. Multivariate statistical methods were used to adjust for patient differences when comparing both short- and long-term outcomes for African American and white veterans.

RESULTS: African Americans were 11% of veterans, and in comparison with their white counterparts had more hypertension, diabetes, and acute myocardial infarction. African Americans less often underwent stenting (44% vs 49%), although hospital mortality (2.0% vs 1.9%) and same-admission bypass surgery (1.9% vs 2.2%) rates were similar. Two-year survival was 89% in African Americans and 91% in white veterans (P =.0014), and after adjustment for covariates African Americans had slightly higher mortality rates (hazard ratio 1.11, 95% confidence interval 1.05-1.17). At 2 years almost 61% of both African American and white veterans were rehospitalized for any reason.

CONCLUSION: Short- and long-term outcomes for African American and white veterans undergoing PCI in VA medical centers were similar, although African Americans underwent stenting less often.