Relationship of race/ethnicity with door-to-balloon time and mortality in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction: findings from Get With the Guidelines-Coronary Artery Disease.
Clin Cardiol
; 36(12): 749-56, 2013 Dec.
Article
en En
| MEDLINE
| ID: mdl-24085713
ABSTRACT
BACKGROUND:
Prior studies have described racial/ethnic disparities in door-to-balloon (DTB) time for patients undergoing primary percutaneous coronary intervention (PCI). We sought to compare DTB time between different racial/ethnic groups undergoing primary PCI for ST-elevation myocardial infarction in Get With the Guidelines (GWTG).HYPOTHESIS:
There may be differences in D2B time associated with race/ethnicity.METHODS:
We identified 7445 white (n = 6365), African American (n = 568), and Hispanic (n = 512) patients undergoing primary PCI.RESULTS:
There were no differences in the median DTB time between white (74 minutes; intraquartile range [IQR], 54-99), African American (77 minutes; IQR, 57-100), and Hispanic (75 minutes; IQR, 56-100) (P = 0.13) patients. There were no crude differences in DTB time ≤90 minutes; however, after adjusting for confounders, African American race was associated with lower odds of DTB time ≤90 minutes (odds ratio [OR] 0.84; 95% confidence interval [CI] 0.70-0.99; P = 0.04). This association was seen in African American males (OR 0.66; 95% CI 0.55-0.80) but not African American females (OR 1.27; 95% CI 0.96-1.68). Overall, Hispanic ethnicity was not associated with a difference in DTB time ≤90 minutes (OR 0.98; 95% CI 0.77-1.25; P = 0.88); although Hispanic males did have a slightly longer median DTB time compared with whites. During the study, the proportion of patients with DTB times ≤90 minutes increased for all groups, and mortality was similar between groups (white 3.8%, African American 3.0%, Hispanic 4.1%, P = 0.62).CONCLUSIONS:
In GWTG-Coronary Artery Disease, small differences in DTB times persist among different races/ethnicities. However, the proportion achieving DTB times ≤90 minutes has increased substantially for all patients over time, and there was no association between race/ethnicity and in-hospital mortality.
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Bases de datos:
MEDLINE
Asunto principal:
Negro o Afroamericano
/
Hispánicos o Latinos
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Población Blanca
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Disparidades en Atención de Salud
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Tiempo de Tratamiento
/
Intervención Coronaria Percutánea
/
Infarto del Miocardio
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Clin Cardiol
Año:
2013
Tipo del documento:
Article