Risk Predictors of Race Disparity in Patients Undergoing Coronary Artery Bypass Grafting. A Propensity Matched Analysis.

To compare long-term prognosis after isolated coronary artery bypass grafting (CABG) between white and black patients, and to investigate risk factors for poorer outcomes among the latest. All consecutive 4,766 black and white patients undergoing isolated CABG between 05/2005 and 06/2021 at our institution were included. Primary outcomes were long-term incidence of all-cause death and major adverse cardiovascular and cerebrovascular events in black vs white patients. A propensity-matched analysis was used two compare groups. After matching, 459 patients were included in each black and white groups while groups were correctly balanced. Mean age was 70.4 vs 70.6-year-old (p = 0.7) in black and white groups, respectively. Intraoperatively, mean operating room time and blood product transfusion, were higher in the black group while incidence of extubation in the operating room was higher in the white one. Postoperatively, hospital length of stay was higher in the black cohort. Thirty-day all cause mortality was not different among groups. Median follow-up time was 4-years. Primary outcome of all-cause death was higher in the black vs the white, respectively. Major adverse cardiovascular and cerebrovascular events incidence was twice higher in the black compared to the white cohort (7.6% vs 3.7%, p = 0.013). Risk-predictors for all-cause death and major adverse cardiovascular and cerebrovascular events in blacks were creatinine level, chronic obstructive pulmonary disease, ejection fraction < 50%, and pre-operative atrial fibrillation. Racial disparities persist in a high-volume center. Despite no pre-operative difference, black minority has a higher incidence of major adverse cardiovascular and cerebrovascular events.

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© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.