Black patients fare worse than white patients after angioplasty and stents

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By Alan Mozes

health day reporter

WEDNESDAY, November 30, 2022 (HealthDay News) — Black adults who undergo a common procedure to open clogged arteries are more likely to be hospitalized again than their white peers. They’re also more likely to die in the years following treatment, a new study shows.

Researchers looked at how patients were doing after balloon angioplasty and a coronary stent — “one of the most common cardiovascular procedures performed in the United States,” said study co-author Dr. Devraj Sukul.

“We found significant differences in post-discharge outcomes such as readmission and long-term mortality,” said Sukul, an interventional cardiologist at the University of Michigan.

The minimally invasive treatment is routinely offered to adults who have been diagnosed with narrowing of the coronary arteries. Doctors use a balloon to dilate the artery and often insert a short wire-mesh tube (stent) to keep the artery open.

Researchers analyzed data from 29,000 Michigan men and women over the age of 65. They found that black patients were 62% more likely to be readmitted to the hospital in the first 90 days after the procedure. And over about four years, black patients were 45% more likely to die than white patients.

In addition, three quarters of white patients were referred for cardiac rehabilitation compared to less than 60% of black patients.

The results were published in the January 2023 issue of the American Heart Journal.

Delmonte Jefferson, executive director of the national nonprofit Center for Black Health & Equity, said he was unsurprised by the results.

“African American health and wellness is not valued in the US,” Jefferson said.

“Once we begin to value optimal health for all,” Jefferson said, “we will see changes in our country’s infrastructure that will lead to better access to health care and better prevention mechanisms to reduce health disparities.”

The study involved more than 26,000 white patients and approximately 3,000 black patients. All underwent artery dilatation procedures at one of 48 Michigan hospitals between 2013 and 2018.

Investigators did not find major differences in outcomes after the procedure while the patients were still in the hospital.

But after accounting for age and gender differences, they found a clear racial gap in patient experience after discharge.

“There are many factors that likely explain this gap,” Sukul said, pointing to sharp disparities in wealth, overall health, and access to health care. By any measure, black patients were, on average, worse off than their white counterparts when they underwent stenting.

These factors are interconnected and add up over time, he added.

For example, Sukul noted, “Lower socioeconomic status can potentially lead to poorer health, just as illness can undermine financial security and economic opportunity.”

To close the gap, the researchers called for better heart health care, both by reducing the risk of heart disease before procedures and by improving follow-up care.

More broadly, Sukul said, “Tackling the root cause of structural barriers to health equity, such as access to quality healthcare, economic mobility and adequate health insurance coverage, will remain crucial.

“None of them are easy [fixes],” Sukul conceded, “but they are important.”

More information

University of Chicago Medicine has more on race differences and heart health.

SOURCES: Devraj Sukul, MD, MSc. Interventional Cardiologist and Clinical Assistant Professor, Department of Internal Medicine, Department of Cardiovascular Medicine, University of Michigan, Ann Arbor; Delmonte Jefferson, executive director, Center for Black Health & Equity, Durham, NC; American Heart Journal, January 2023

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Black patients fare worse than white patients after angioplasty and stents
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