Racial and Ethnic Disparities in Rates of Peripheral Vascular Interventions

Black and Hispanic patients with peripheral vascular disease experience lower rates of utilization of interventions, including peripheral vascular interventions (PVIs), overall. These findings were presented at the Transcatheter Cardiovascular Therapeutics (TCT) Scientific Symposium 2022 held from September 17th through 19th, in Boston, Massachusetts.

Researchers sought to explore racial and ethnic disparities in rates of PVI utilization. They used data from the Healthcare Cost and Utilization Project National Inpatient Sample to identify all patients aged 65 years or older diagnosed with peripheral artery disease (PAD) who had received infrailiac PVI between 2010 and 2017. Comparisons were made regarding demographic and socioeconomic data, pre-existing disorders, and outcomes among non-Hispanic White, Black, and Hispanic participants.

A total of 9,637,980 hospital admissions involving a PAD diagnosis and 436,278 PVIs were identified. Non-Hispanic White patients, Black patients, and Hispanic patients were aged 76±7, 74±7, and 75±7 years; 44.2%, 53.3%, and 44.9% were women; and 91.4%, 89.3%, and 83.2% paid with Medicare, respectively. Results of the study showed that Black and Hispanic patients who receive PVI experience more comorbidities (dyslipidemia, hypertension, diabetes, congestive heart failure, chronic kidney disease, and chronic obstructive pulmonary disease) and have a lower socioeconomic status compared with non-Hispanic White patients.

PVI is utilized less among Hispanic and Black patients compared with non-Hispanic White patients. When the percentage of PVIs is adjusted for the total number of hospitalizations, however, findings show that Black and Hispanic patients receive more PVIs and amputations, and have higher odds of experiencing periprocedural complications. 

Although rates of amputation downtrended for all patients during the study period, Hispanic and Black patients still were shown to have significantly higher rates of amputation (P <.001), which suggests suggesting that Hispanic and Black individuals present at later stages of PAD.

The researchers concluded that “Black and Hispanic patients who undergo PVI have a higher likelihood of experiencing complications during their admission.”