Key result
In-hospital freedom from major adverse cardiac events following coronary orbital atherectomy was high and similar between Hispanic/Latino and non-Hispanic/Latino patients (98.6% vs. 98.5%, p=1.00).
Why the study?
Hispanic or Latino patients have greater cardiovascular disease mortality risk than Whites with similar coronary calcium scores, but the safety and efficacy of coronary atherectomy in this population is unknown.
Does coronary orbital atherectomy result in similar in-hospital MACE rates in Hispanic/Latino patients compared to non-Hispanic/Latino patients with severely calcified lesions?
Cohort (n=609)
No
Does coronary orbital atherectomy result in similar in-hospital MACE rates in Hispanic/Latino patients compared to non-Hispanic/Latino patients with severely calcified lesions?
Absolute Event Rate: 98.6% vs 98.5%
p-value: p=1.00
Coronary orbital atherectomy can be performed safely and effectively in Hispanic/Latino patients with severely calcified lesions, yielding in-hospital outcomes similar to those of non-Hispanic/Latino patients.
Supports equitable in-hospital outcomes with orbital atherectomy; extends evidence to Hispanic/Latino patients but leaves open prospective validation.
OBJECTIVES: To assess coronary orbital atherectomy (OA) use in Hispanic or Latino (HL) patients compared to non-HL patients. BACKGROUND: HL patients are at greater risk of cardiovascular disease mortality compared with Whites with similar coronary artery calcium (CAC) scores. The safety and efficacy of coronary atherectomy in the HL patient population is unknown due to the under-representation of minorities in clinical trial research. METHODS: A retrospective analysis of consecutive patients undergoing coronary OA treatment of severely calcified lesions at the Mount Sinai Medical Center, Miami Beach, Florida (MSMCMB) was completed. From January 2014 to September 2020, a total of 609 patients from MSMCMB who underwent percutaneous coronary intervention with OA were identified in the electronic health records. RESULTS: Of those identified, 350 (57.5%) had an ethnicity classification of HL. The overall mean age was 74 years and there was a high prevalence of diabetes in the HL group compared to the non-HL group (49.7% vs. 34.7%; p = 0.0003). Severe angiographic complications were uncommon and in-hospital freedom from major adverse cardiac events (MACE), a composite of cardiac death, MI, and stroke (ischemic or hemorrhagic cerebrovascular accidents), was 98.5% overall, with no significant difference between the HL and non-HL groups, despite the higher prevalence of diabetes in the HL group. CONCLUSIONS: This study represents the largest real-world experience of OA use in HL versus non-HL patients. The main finding in this retrospective analysis is that OA can be performed safely and effectively in a high-risk population of HL patients.
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Beohar et al. (2022) conducted a cohort in Severely calcified coronary lesions requiring percutaneous coronary intervention (n=609). Hispanic or Latino ethnicity vs. Non-Hispanic or Latino ethnicity was evaluated on In-hospital freedom from major adverse cardiac events (MACE), a composite of cardiac death, MI, and stroke (p=1.00). In-hospital freedom from major adverse cardiac events following coronary orbital atherectomy was high and similar between Hispanic/Latino and non-Hispanic/Latino patients (98.6% vs. 98.5%, p=1.00).
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