Racial differences in outcomes of veterans undergoing percutaneous coronary interventions

Background In the era of stenting relatively little is known about racial d ifferences 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 tr eatment 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 co morbidity. Short-term outcomes included hospital mortality and same-admissi on coronary artery bypass surgery, and long-term outcomes were vital status and rehospitalization. Multivariate statistical methods were used to adjus t 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 thei r white counterparts had more hypertension, diabetes, and acute myocardial infarction. African Americans less often underwent stenting (44% vs 49%), a lthough 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 Am ericans and 91% in white veterans (P=.0014), and after adjustment for covar iates 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 Afri can American and white veterans were rehospitalized for any reason. Conclusion Short- and long-term outcomes for African American and white vet erans undergoing PCI in VA medical centers were similar, although African A mericans underwent stenting less often.