Coronary disease & ACSCohort study
Impact of name-based implicit bias on time to diagnosis and outcomes in ST-elevation myocardial infarction
- prospective registry
- consecutive ST-elevation myocardial infarction (STEMI) patients
- June 2008 to November 2024
Authors' conclusion
Patients with phonetically uncommon surnames experienced significant STEMI diagnostic delays within an efficient fast-track network. Protocol-driven care following diagnosis operated equitably, leading to no difference in long-term MACE.
Study context
- Population
- STEMI patients within an established fast-track network, with surnames classified as phonetically common or uncommon against Canton Fribourg population data
- Participants
- 1,208 patients
- Exposure
- patients with phonetically uncommon surnames compared with patients with common surnames
- uncommon namesn = 284
Main finding
FMC-to-diagnosis time
Mean difference
+16.8 min
P = 0.009
By group
As reported in the abstract
Observational data: associations, not effects.
Further findings
FMC-to-balloon time · prolonged with uncommon names
mean difference +17.5 · P = 0.016
| Outcome | mean difference (U/L) | P value |
|---|---|---|
| Peak creatine kinase muscle-brain · non-significant elevation | +52.0 | P = 0.077 |
Exceeding the 90 min first medical contact (FMC)-to-balloon threshold
- uncommon names significantly more likely to exceed; printed as
- 39.2% vs 48.4%; p=0.010
Exceeding the 120 min FMC-to-balloon threshold
- uncommon names significantly more likely to exceed; printed as
- 16.4% vs 23.5%; p=0.018
Diagnosis-to-balloon time
- remained unaffected
- P > 0.80
MACE · 30 days and 5 years
- No differences between patients with common and uncommon names
Original publication
Impact of name-based implicit bias on time to diagnosis and outcomes in ST-elevation myocardial infarction. Heart. Published 23 February 2026. doi:10.1136/heartjnl-2025-327383
Summarised from the published abstract; every number is checked against it