Clinical outcomes and cardiac rehabilitation in underrepresented groups after percutaneous coronary intervention: an observational study

Gonzalez Jaramillo, Nathalia; Marcin, Thimo; Matter, Sophia; Eser, Prisca; Berlin, Claudia; Bano, Arjola; Heg, Dik; Franco, Oscar H; Windecker, Stephan; Räber, Lorenz; Wilhelm, Matthias (2022). Clinical outcomes and cardiac rehabilitation in underrepresented groups after percutaneous coronary intervention: an observational study. European journal of preventive cardiology, 29(7), pp. 1093-1103. SAGE Publications 10.1093/eurjpc/zwab204

Gonzalez-Jaramillo_EurJPrevCardiol_2022.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC).

Download (1MB) | Preview


Aims: Underrepresentation of migrants, women, and older adults in cardiovascular disease (CVD) trials may contribute to disparate care and survival. Among patients who underwent percutaneous coronary intervention (PCI), we aimed to investigate the associations of (i) underrepresented groups with major adverse cardiac events (MACE), CVD mortality, and non-CVD mortality, (ii) underrepresented groups with cardiac rehabilitation (CR) uptake, and (iii) CR uptake with outcomes.

Methods and results: We included 15 211 consecutive patients from the CARDIOBASE Bern PCI registry (2009-18). In multi-state models comparing transition probabilities of events, sex was not associated with increased risk of any event. For each year increase in age, the increased risk of non-CVD and CVD mortality was 8% [95% confidence interval (CI) 6-9%]. Being migrant was associated with a lower risk of non-CVD mortality [hazard ratio (HR) (95% CI) 0.49 (0.27-0.90)] but not with CVD mortality. In logistic regression analysis, CR uptake was lower among women [odds ratio (95% CI) = 0.72 (0.57-0.86)] and older adults [0.32 (0.27-0.38)], but not among migrants. In cox regression, CR was independently associated with lower all-cause [HR (95% CI) = 0.12 (0.03-0.37)] and CVD mortality [0.1 (0.02-0.7)], but not with MACE [1.08 (0.8-1.4)].

Conclusion: Among underrepresented groups undergoing PCI, age, but not migration status nor sex, contributed to disparities in mortality. Migrant status did not result in lower attendance of CR. Considering the protective associations of CR on CVD mortality independent of age, sex, and migration status, the lower uptake in women and older adults is noteworthy.

Keywords: Cardiac rehabilitation; Coronary artery disease; Migrants; Older adults; Percutaneous coronary intervention; Women.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Department of Clinical Research (DCR)
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Gonzalez Jaramillo, Nathalia, Marcin, Thimo, Eser, Prisca Christina, Berlin, Claudia, Bano, Arjola, Heg, Dierik Hans, Franco Duran, Oscar Horacio, Windecker, Stephan, Räber, Lorenz, Wilhelm, Matthias


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services




SAGE Publications




Matthias Wilhelm

Date Deposited:

13 Dec 2021 15:28

Last Modified:

20 Feb 2024 14:16

Publisher DOI:


PubMed ID:


Additional Information:

The first two authors Nathalia Gonzalez-Jaramillo and Thimo Marcin contributed equally to the study.




Actions (login required)

Edit item Edit item
Provide Feedback