Adjunctive Imaging and Physiology During Percutaneous Coronary Intervention (PCI) Among Black and White Medicare Beneficiaries: Disparities in Utilization Patterns and Outcomes
Authors' conclusion
IVI- and IP-guided PCI were associated with improved outcomes in both Black and White beneficiaries, yet these technologies were less frequently used in Black adults, and overall PCI outcomes remained worse for this group.
Study context
- Population
- Black and White Medicare Fee-For-Service beneficiaries undergoing percutaneous coronary intervention (PCI), 2016–2023PCI patients (5.9% Black patients, 63.6% male, mean age 75.3±7.0 years)
- Participants
- 1,481,343 participants
- Comparison
- Black versus White race; Intravascular imaging (IVI) versus none; Invasive physiology (IP) versus none
- Outcome
- Major adverse cardiovascular events:
- Myocardial infarction
- Repeat revascularization
- Death
- Follow-up
- 2 years
Methodological detailsmultivariable logistic regression, Cox regression adjusting for all baseline characteristics
- Multivariable logistic regression
- Cox regression adjusting for all baseline characteristics
Main finding
As reported in the abstract
Major adverse cardiovascular events:
- Myocardial infarction
- Repeat revascularization
- Death
Hazard ratio (95% CI)
IVI vs angiography aloneWhite patients
0.93(0.92–0.94)
IVI vs angiography aloneBlack patients
0.85(0.84–0.87)
IP vs angiography aloneWhite patients
0.95(0.92–0.98)
IP vs angiography aloneBlack patients
0.87(0.83–0.91)
Black patients vs White patientsadjusted; higher risk in Black adults
1.02(1.01–1.03)
Further findings
| Outcome | White patients | Black patients | Odds ratio (95% CI) | |
|---|---|---|---|---|
| IVI and IP use · IVI; adjusted; less likely in Black adults | 0.94 (0.93–0.96) | |||
| IVI | 17.6% | 15.0% | ||
| IP | 7.1% | 5.7% | ||
| IVI and IP use · IP; adjusted; less likely in Black adults | 0.83 (0.81–0.85) | |||
| 0.512Odds ratio (log scale) |
Original publication
Adjunctive Imaging and Physiology During PCI Among Black and White Medicare Beneficiaries: Disparities in Utilization Patterns and Outcomes. Circ Cardiovasc Interv. Published 27 August 2025. doi:10.
Summarised from the published abstract; every number is checked against it