Key result
Roma ethnicity is linked to ~51% higher long-term mortality after PCI compared to Romanian patients.
Why the study?
Long-term cardiovascular outcomes are historically under-reported in Eastern Europe, particularly regarding under-resourced minorities such as Hungarian and Roma ethnicities.
Does ethnicity impact long-term cardiovascular and all-cause mortality in an all-comers population undergoing percutaneous coronary intervention in Romania?
Cohort (n=6,867)
No
Does ethnicity impact long-term cardiovascular and all-cause mortality in an all-comers population undergoing percutaneous coronary intervention in Romania?
Ethnic minorities (Hungarian and Roma) in Romania undergoing PCI experience significantly higher long-term cardiovascular and all-cause mortality compared to the majority Romanian population, highlighting important healthcare disparities.
Answers are grounded in this paper and cite their sources.
Ethnic disparities may warrant closer post-PCI monitoring; leaves open causal pathways and targeted interventions.
BACKGROUND: Long-term outcomes in cardiovascular diseases are historically under-reported in Eastern Europe. Our aim was to report long-term survival and to identify survival predictors in a prospective Romanian percutaneous coronary intervention (PCI) registry, with an emphasis on important under-resourced minorities, such as Hungarian and Roma ethnicities. METHODS: An all-comers patient population treated by PCI in a tertiary cardiovascular centre that has been included prospectively in the local registry since January 2016 was analysed. Cardiovascular cause and all-cause mortality data were available as of December 2023. RESULTS: A total of 6867 patients with 8442 PCI procedures were included. Romanian group consisted of 5095 (74.2%) patients, the Hungarian group consisted of 1417 (20.6%) patients and the Roma group consisted of 355 (5.1%) patients. During a median follow-up of 3.60 (1.35-5.75) years, a total of 1064 cardiovascular-cause and 1374 all-cause events occurred. Romanian, Hungarian and Roma patients suffered 5.12, 5.89 and 7.71 all-cause deaths per 100 patient-years, respectively. Romanian, Hungarian and Roma patients suffered 3.94, 4.63 and 6.22 cardiovascular-cause deaths per 100 patient-years, respectively. Both Hungarian and Roma patients presented significantly higher all-cause mortality than Romanian patients (adjusted HR (aHR)=1.20 (1.05-1.36), p=0.005 and aHR=1.51 (1.21-1.88), p=0.0001). Similarly, Hungarian and Roma patients presented significantly higher cardiovascular cause mortality than Romanian patients (aHR=1.22 (1.05-1.41), p=0.006 and aHR=1.51 (1.18-1.92), p=0.0008). CONCLUSIONS: High long-term cardiovascular and all-cause mortality was observed for the entire included population. Long-term survival was significantly lower in ethnic minorities, such as the Hungarian and Roma minority than in the Romanian population.
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Călburean et al. (2024) conducted a cohort in Ischaemic heart disease (n=6,867). Roma ethnicity vs. Romanian ethnicity was evaluated on All-cause mortality (aHR 1.51, 95% CI 1.21-1.88, p=0.0001). Roma and Hungarian ethnic minorities undergoing PCI had significantly higher long-term all-cause mortality compared to Romanian patients (aHR 1.51, P=0.0001 and aHR 1.20, P=0.005, respectively).
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