Coronary disease & ACSResearch article
Impact of Area-Level Socioeconomic Deprivation on Post-PCI Outcomes Stratified by P2Y12 Inhibitor Therapy
- Data abstracted from electronic health records
- 3 institutions
- multivariable Cox regression
Authors' conclusion
Higher SDI was associated with an increased risk of MAE with clopidogrel and bleeding with alternative therapy following PCI. Whether addressing socioeconomic disparities improves P2Y12 inhibitor-related outcomes remains to be determined.
Study context
- Population
- Adults who underwent postpercutaneous coronary intervention (PCI) and clinical cytochrome P450 2C19 genotyping and received a P2Y12 inhibitormean age: 63 years, 33% female, 68% with acute coronary syndrome · clopidogrel-treated patients 1,852 · patients on alternative therapy 1,289
- Participants
- 3,141 adults
- Comparison
- Association between Social Deprivation Index (SDI) and Social Vulnerability Metric (SVM) (per unit increase) and risk for major atherothrombotic events (MAE) and bleeding with clopidogrel and alternative therapy
- clopidogreln = 1,852
- alternative therapyn = 1,289
Main finding
As reported in the abstract
MAE (death, myocardial infarction, stent thrombosis, ischemic stroke, or revascularization for unstable angina)
SDI (per unit increase)Adjusted hazard ratio (95% CI)P value
clopidogrel-treated patients; higher risk
1.009(1.001–1.016)
P = 0.018patients on alternative therapy
0.998(0.988–1.007)
P = 0.652Per unit increase, as printed
Further findings
SVM and adverse outcomes
- SVM was not significantly associated with adverse outcomes with clopidogrel or alternative therapy after adjustment
Safety
| Outcome | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| Bleeding (Global Use of Strategies to Open Occluded Coronary Arteries Moderate-Severe) — SDI (per unit increase) · clopidogrel-treated patients | 1.001 (0.990–1.012) | P = 0.838 | |
| Bleeding (Global Use of Strategies to Open Occluded Coronary Arteries Moderate-Severe) — SDI (per unit increase) · patients on alternative therapy; higher risk | 1.014 (1.001–1.028) | P = 0.048 | |
| 0.512Adjusted hazard ratio (log scale) |
Original publication
Impact of Area-Level Socioeconomic Deprivation on Post-PCI Outcomes Stratified by P2Y12 Inhibitor Therapy. JACC Adv. Published 3 February 2026. doi:10.1016/j.jacadv.2025.102577
Summarised from the published abstract; every number is checked against it