Short-Term Clinical Outcomes After Percutaneous Coronary Intervention Among Culturally and Linguistically Diverse (CALD) Patients in Australia.

AIMS: We aimed to evaluate the effect of culturally and linguistically diverse (CALD) status on clinical outcome as measured by 30-day major adverse cardiac and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI).

METHODS

This observational cohort study involved analysis of data from a high-volume tertiary centre in Melbourne, Australia. Adults who underwent PCI at a tertiary health service in Melbourne, Australia (January 2014-December 2021), were stratified into CALD (those born in non-English-speaking countries and/or whose primary language at home is not English) and non-CALD status. The main outcome measures were in-hospital and 30-day MACCE (composite of new heart failure, myocardial infarction, stent thrombosis, major bleeding, stroke, rehospitalisation, and mortality).

RESULTS

Compared to non-CALD (n=3,301, 51%), CALD patients (n=3,112, 49%) were older (mean age 65.2 vs. 61.5 years), more likely to be on medication for type 2 diabetes mellitus (33.5% vs 21.7%), had prior coronary artery bypass grafting (5.5% vs 3.7%) and were on dialysis (2.2% vs 1.0%; all p<0.001). CALD patients presented less frequently with acute coronary syndromes (58.7% vs 65.8%; p<0.001) but had increased rates of multivessel disease (8.9% vs 6.9%; p=0.004). In the ST-elevation myocardial infarction subgroup, CALD patients had lower pre-hospital notification rates (13.1% vs 20.7%) and longer symptom to PCI time (599 vs 420 minutes; both p<0.001). At 30 days, CALD patients had higher rates of rehospitalisation (13.9% vs 11.9%) and major bleeding (0.5% vs 0.1%; both p=0.05) but not overall MACCE (5.0 vs. 5.9%; p=0.12) or mortality (2.8% vs. 3.3%; p=0.28).

CONCLUSIONS

Despite higher rates of co-morbidities, re-hospitalisation and major bleeding, CALD patients had comparable 30-day mortality compared to non-CALD patients in contemporary systems of care. These data suggest that evolving changes within care network tailored to CALD patient needs might be beneficial and require further prospective studies.