title: The association between patient race, treatment, and outcomes of patients undergoing contemporary percutaneous coronary intervention: insights from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2).
abstract: BACKGROUND
  The aim of this study was to examine if racial disparities exist in the treatment and outcomes of patients undergoing contemporary percutaneous coronary intervention (PCI).
  
  
  METHODS
  We examined the association between race, process of care, and outcomes of patients undergoing PCI between January 1, 2010, and December 31, 2011, and enrolled in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium. We used propensity matching to compare the outcome of black and white patients.
  
  
  RESULTS
  The study cohort comprised 65,175 patients, of whom 6,873 (10.5%) were black and 55,789 (85.6%) were white. Black patients were more likely to be younger, be female, have more comorbidities, and be uninsured. Overall, black patients were less likely to receive prasugrel (10.0% vs 14.5%, P < .001) and drug-eluting stents (62.5% vs 67.7%, P < .001), largely related to lower use of these therapies in hospitals treating a higher proportion of black patients. No differences were seen between white and black patients with regard to inhospital mortality (odds ratio 1.34, 95% CI 0.82-2.2, P = .24), contrast-induced nephropathy (OR 1.06, 95% CI 0.81-1.40, P = .67), and need for transfusion (OR 1.27, 95% CI 0.98-1.64, P = .06). White race was associated with increased odds of heart failure (OR 1.48, 95% CI 1.05-2.08, P = .024) and vascular complications (OR 1.40, 95% CI 1.03-1.90, P = .032).
  
  
  CONCLUSIONS
  Compared with white patients, black patients undergoing PCI have a greater burden of comorbidities but, after adjusting for these differences, have similar inhospital survival and lower odds of vascular complications and heart failure after PCI.
authors.affiliation: The Department of Cardiology, St John Hospital and Medical Center, Detroit, MI, USA.
authors.forename: Sherezade
authors.initials: S
authors.lastname: Khambatta
authors.forename: Milan
authors.initials: M
authors.lastname: Seth
authors.forename: Howard S
authors.initials: HS
authors.lastname: Rosman
authors.forename: David
authors.initials: D
authors.lastname: Share
authors.forename: Herbert D
authors.initials: HD
authors.lastname: Aronow
authors.forename: Mauro
authors.initials: M
authors.lastname: Moscucci
authors.forename: Thomas
authors.initials: T
authors.lastname: Lalonde
authors.forename: Simon R
authors.initials: SR
authors.lastname: Dixon
authors.forename: Hitinder S
authors.initials: HS
authors.lastname: Gurm
mesh_terms: D001741:Black or African American; D000368:Aged; D054598:Blue Cross Blue Shield Insurance Plans; D003324:Coronary Artery Disease / Q000191:economics / Q000208:ethnology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D017063:Outcome Assessment, Health Care; D062645:Percutaneous Coronary Intervention / Q000191:economics / Q000379:methods*; D057216:Propensity Score; D044469:Racial Groups; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D044465:White People