Racial and Ethnic Diversity in Endovascular Thrombectomy Trials

IF 2.1 Q3 CLINICAL NEUROLOGY Stroke (Hoboken, N.J.) Pub Date : 2023-08-07 DOI:10.1161/svin.123.000613
G. Silva, Eva A. Rocha, Amol Mehta, A. Sharrief
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Abstract

The burden of acute ischemic stroke varies among racial and ethnic groups. Black adults face a higher incidence of stroke as well as higher rates of mortality. Thrombolytic therapy is under‐utilized in Black adults, and recent data show that endovascular thrombectomy is also under‐utilized for Black and Hispanic adults in the United States. Despite federal initiatives designed to promote the representation of diverse racial and ethnic groups in academic research, Black and Hispanic adults continue to be underrepresented in clinical trials conducted in the United States. Globally, the lack of standardization regarding race and ethnicity reporting makes it challenging to determine the overall diversity of trial enrollment. In this topical review, we provide an overview of racial and ethnic disparities in stroke incidence and clinical care with a focus on endovascular thrombectomy and follow this with a description of diversity reporting in endovascular thrombectomy trials. We conclude with opportunities for and barriers to increasing racial and ethnic diversity in endovascular thrombectomy trials.
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血管内取栓试验中的种族和民族多样性
急性缺血性脑卒中的负担因种族和民族而异。黑人成年人面临着更高的中风发病率和更高的死亡率。溶栓治疗在黑人成年人中的应用不足,最近的数据显示,在美国黑人和西班牙裔成年人中,血管内取栓术的应用也不足。尽管联邦政府旨在促进学术研究中不同种族和民族群体的代表性,但在美国进行的临床试验中,黑人和西班牙裔成年人的代表性仍然不足。在全球范围内,缺乏关于种族和民族报告的标准化使得确定试验入组的总体多样性具有挑战性。在这篇专题综述中,我们概述了脑卒中发病率和临床护理的种族和民族差异,重点是血管内血栓切除术,然后描述了血管内血栓切除术试验的多样性报告。我们总结了在血管内血栓切除术试验中增加种族和民族多样性的机会和障碍。
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