Coronary orbital atherectomy treatment of Hispanic and Latino patients: A real-world comparative analysis

Catheter Cardiovasc Interv. 2022 May;99(6):1752-1757. doi: 10.1002/ccd.30158. Epub 2022 Mar 21.

Abstract

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.

Keywords: Hispanic/Latino; atherectomy; coronary artery calcification; percutaneous coronary intervention.

MeSH terms

  • Aged
  • Atherectomy
  • Atherectomy, Coronary* / adverse effects
  • Coronary Angiography
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / surgery
  • Diabetes Mellitus*
  • Hispanic or Latino
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome
  • Vascular Calcification* / diagnostic imaging
  • Vascular Calcification* / etiology
  • Vascular Calcification* / therapy