Disparities in access, utilization, and outcomes of percutaneous coronary intervention in Hispanics compared to non-Hispanic Whites in the United States: A comprehensive review.

Abstract

Background: Ischemic heart disease is the leading cause of cardiovascular mortality in the United States, with percutaneous coronary intervention (PCI) being one of the definitive treatments. Historically, data suggested Hispanics, when compared to non-Hispanic Whites, suffer worse acute coronary syndrome mortality rates. Therefore, we conducted a comprehensive literature review to summarize factors influencing PCI outcomes in this population.

Methods: In accordance with PRISMA guidelines for systematic reviews, we performed a literature search encompassing PCI for any indication with Hispanic-specific outcomes using the PubMed database through April 2025 yielding 69 studies. Authors independently screened search results and resolved discrepancies through consensus. Meta-analysis was performed where ever feasible using random effects models due to expected study heterogeneity.

Results/data: Hispanics experience acute myocardial infarction more frequently and are more likely to present urgently or emergently than Whites. Hispanic ethnicity correlates with delayed door-to-balloon and catheterization laboratory activation times. Additionally, Hispanics are disproportionately admitted to low procedure volume hospitals with disparities in hospital quality resulting in inferior PCI outcomes. High Medicaid and uninsured rates in Hispanics reflect cost-prohibitive healthcare access limitations, resulting in a trend towards lower rates of resvascularization and procedural differences like stent utilization. However, in-hospital and long-term outcomes between Hispanic and White populations undergoing PCI are similar.

Conclusion(s): This review uncovers an incongruity between profound disparities in access and utilization of PCI, driven by socio-economic determinants, and comparable in-hospital and mortality outcomes between Hispanics and Whites. Consequently, it highlights the need for increased research to improve patient outcomes and reduce health disparities.