Racial Disparity Between the Post-Procedural Outcomes Among Patients With Peripheral Artery Disease: A Systematic Review and Meta-analysis

The Racial disparity between the clinical outcomes post interventions among Peripheral Artery Disease (PAD) have not been well studied, with limited literature available. We conducted a meta-analysis to evaluate the post-procedure outcomes among PAD patients between Black and White race. We systematically searched all electronic databases from inception until first November 2022. The primary endpoint was major amputation within 30 days. Secondary endpoints were myocardial infarction (MI) within 30 days, mortality within 30 days, and all-cause mortality (ACM). A total of 136,395 patients were included in the analysis, with 117,177 patients of the White race and 19,218 patients of the Black race. The mean age of the patients in each group was (66.41 vs 62.75). Most common comorbidity among White and Black patients was diabetes mellitus (42.15% vs 55.90%), and hypertension (HTN) (39.53% vs 90.07%). The odds of major amputation within 30 days was significantly higher in Black patients compared to white patients (OR, 0.40 (95% CI: 0.19-0.84, P = 0.02), while the odds of MI was higher in White patients compared to Black race PAD patients (OR, 1.29, (95%CI:1.05-1.58), P < 0.02). There was no significant difference in ACM (OR, 0.97(95%CI: 0.64-1.47, P = 0.88), and mortality within 30 days (OR, 1.09(95%CI:0.77-1.53, P = 0.64) between both groups. To our knowledge, this is the first meta-analysis with the largest sample size thus far, highlighting that Black patients are at a higher risk for major amputation within 30 days compared to white patients although mortality remains comparable between the 2 races.