Study Analyzes Outcome Disparities for Black Patients With CLTI

May 7, 2025—The Society for Cardiovascular Angiography & Interventions (SCAI) recently announced the presentation of findings showing that Black patients with chronic limb-threatening ischemia (CLTI) face a significantly higher combined rate of major amputation and death, and are 10% more likely to require emergency care because of their condition.

SCAI reported that approximately 20% of patients with CLTI are Black and that Black patients have a 46% higher chance of amputation after CLTI.

The data were presented at the SCAI 2025 scientific sessions held May 1-3 in Washington, DC. The SCAI abstract of the study by Joseph Kim, MD, et al is available online in JSCAI. Dr. Kim is from Beth Israel Deaconess Medical Center in Boston, Massachusetts.

According to SCAI, efforts to raise awareness of unequal outcomes in PAD have increased; however, few studies have examined how care and results differ across socioeconomic groups. To address this gap, this study was conducted to analyze access to care and clinical outcomes among Black and White patients using data from a large, contemporary population of Medicare beneficiaries.

The analysis included 381,355 individuals who underwent endovascular revascularization for CLTI between 2016 and 2023, reported SCAI.

As summarized in the SCAI press release, the primary outcome—a composite of major amputation and death within 1 year—was experienced by 31.5% of Black patients versus 27.6% of White patients. This difference was driven by a 45.6% higher risk of major amputation for Black patients. Paradoxically, Black patients had a 10% lower risk of mortality compared to White patients, noted SCAI.

Additionally, Black patients were 10% less likely to see a vascular specialist before revascularization and 8% less likely to see a vascular specialist after revascularization. Black patients were 10% more likely to have CLTI-related emergency visits and 26% more likely for admissions compared to White patients.

“Black patients make up nearly 20% of the CLTI population but face nearly a 50% higher risk of amputation compared to White patients,” commented Dr. Kim in the SCAI press release. “These findings highlight the ongoing challenges Black patients face in accessing timely vascular care. While they’re less likely to see a specialist, they’re more likely to need emergency care, underscoring the urgent need for improved care pathways that reach all patients effectively.”

Further research is needed to determine the most effective strategies for early PAD detection and to assess how system-level changes can improve outcomes equitably, advised the SCAI press release.