Work

Impact of Area-Level Socioeconomic Deprivation on Post-PCI Outcomes Stratified by P2Y12 Inhibitor Therapy

Year: 2026

Type: article

Abstract: BACKGROUND: Social deprivation influences postpercutaneous coronary intervention (PCI) outcomes, but whether it affects outcomes by antiplatelet therapy is unknown. OBJECTIVES: inhibitors following PCI was assessed. METHODS: inhibitor across 3 institutions. Social Deprivation Index (SDI) and Social Vulnerability Metric (SVM) were assigned using zip code tabulation areas. Multivariable Cox regression was used to evaluate the association between SDI and SVM (per unit increase) and risk for major atherothrombotic events (MAE) (death, myocardial infarction, stent thrombosis, ischemic stroke, or revascularization for unstable angina) and bleeding (Global Use of Strategies to Open Occluded Coronary Arteries Moderate-Severe) with clopidogrel and alternative therapy (eg, prasugrel or ticagrelor). RESULTS: Overall, 3,141 patients (mean age: 63 years; 33% female; 68% with acute coronary syndrome) were included. In clopidogrel-treated patients (n = 1,852), SDI was associated with higher risk for MAE (adjusted HR: 1.009; 95% CI: 1.001-1.016; P = 0.018) but not bleeding (adjusted HR: 1.001; 95% CI: 0.990-1.012; P = 0.838). In patients on alternative therapy (n = 1,289), SDI was associated with a higher risk for bleeding (adjusted HR: 1.014; 95% CI: 1.001-1.028; P = 0.048), but not MAE (adjusted HR: 0.998; 95% CI: 0.988-1.007; P = 0.652). SVM was not significantly associated with adverse outcomes with clopidogrel or alternative therapy after adjustment. CONCLUSIONS: inhibitor-related outcomes remains to be determined.

Source: JACC Advances

DOI: 10.1016/j.jacadv.2025.102577