Abstract P93: Differences in Practice Patterns and Outcomes Between Hispanics and Non-Hispanic Whites Treated for ST-Segment Elevation Myocardial Infarction: Results From ACTION Registry - Get With the Guidelines
2011; Lippincott Williams & Wilkins; Volume: 4; Issue: suppl_1 Linguagem: Inglês
10.1161/circoutcomes.4.suppl_1.ap93
ISSN1941-7705
AutoresLuis A. Guzmán, Ileana L. Piña, Wang Y Tracy, Larissa Aviles, Martha L. Daviglus, J. Emilio Exaire, Carlos J. Rodríguez, Vilma Torres, Shuang Li, Marjorie Funk, Jorge Saucedo, C. B. Granger, Mauricio G. Cohen,
Tópico(s)Healthcare Systems and Practices
ResumoBackground: Ethnic differences have been reported in the treatment and outcomes of patients with non-ST-segment elevation myocardial infarction (non-STEMI). Potential ethnic disparities in contemporary STEMI management have not been well characterized. Methods: We compared practice patterns and outcomes between 1,654 Hispanics (H) (4.1%) and 38,844 non-Hispanic Whites (NHW) treated for STEMI in ACTION Registry-GWTG between 01-2007 and 03-2009. Logistic generalized estimating equation modeling was used to examine associated risk-adjusted mortality. Results: Hispanic patients more frequently had diabetes (32% vs 21%, p<0.0001), whereas older age (median 61 vs 57, P<0.0001), female gender (30% vs 21%, p<0.0001), smoking (43% vs 38%, p<0.0001), dyslipidemia (55% vs 51%, p<0.006) and prior MI (19% vs 15%, p<0.0002) were more prevalent in the NHW group. While use of acute medications (aspirin, clopidogrel, B Blockers and GPIIb/IIIa inhibitors) was similar between groups, significant differences and delays in initial triage and reperfusion were observed (Table). After adjustment for patient and hospital characteristics, in-hospital mortality was similar in H and NHW patients (OR 1.07; 95% CI 0.81, 1.43, p=0.63). Conclusions: Despite similar in-hospital mortality, Hispanic STEMI patients had significant differences in process of care with longer triage and treatment delays than non-Hispanic Whites. As the fastest growing minority in the United States, this population needs further efforts to optimize their care processes Hispanics Non-Hispanic Whites p value Ambulance use 41.5% 47.0% <0.0001 Pre-Hospital EKG 32.8% 37.5% <0.0001 Onset of pain to arrival (median) 2.0 hrs 1.6 hrs <0.0001 Arrival to EKG (median) 8 min 6 min <0.0001 Arrival to EKG<10 min 61.2% 69.3% <0.0001 Reperfusion therapy 91.6% 93.1% 0.04 Arrival to PCI (median) 74 min 69 min <0.0001 DTB <90 min 69.4% 77.5% <0.0001
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