Coronary disease & ACSCohort study
Race-Based Differences in ST-Segment–Elevation Myocardial Infarction Process Metrics and Mortality From 2015 Through 2021: An Analysis of 178 062 Patients From the American Heart Association Get With The Guidelines–Coronary Artery Disease Registry
- Retrospective cohort study
- registry analysis
- multivariable-adjusted
- analysed separately in women and men
Authors' conclusion
Race- or ethnicity-based disparities persist in STEMI process metrics in both women and men, and mortality differences are observed in Hispanic White compared with non-Hispanic White women.
Study context
- Population
- Patients with STEMI in the AHA Get With The Guidelines-CAD registry, January 1, 2015 to December 31, 202152,293 women · 125,769 men
- Participants
- 178,062 patients
- Exposure
- Hispanic White and Black vs non-Hispanic White patients
- Outcome
- Proportions achieving STEMI process metrics: prehospital ECG by EMS; door-to-ECG within 10 minutes (non-EMS arrivals); arrival-to-PCI within 90 minutes; first medical contact-to-device within 90 minutes
Main finding
As reported in the abstract
STEMI process metrics
- Hispanic White and Black patients had lower odds of prehospital ECG and of achieving door-to-ECG, door-to-device and first medical contact-to-device targets vs non-Hispanic White patients
- Disparities observed in both women and men, and persisted in most cases after multivariable adjustment
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | |
|---|---|---|
| Adjusted in-hospital mortality, women — Hispanic White vs Non-Hispanic White · women | 1.39 (1.12–1.72) | |
| Adjusted in-hospital mortality, women — Black vs Non-Hispanic White · women | 0.88 (0.74–1.03) | |
| Adjusted in-hospital mortality, men — Hispanic White vs Non-Hispanic White · men | 0.99 (0.82–1.18) | |
| Adjusted in-hospital mortality, men — Black vs Non-Hispanic White · men | 0.96 (0.85–1.09) | |
| 0.512Odds ratio (log scale) |
Original publication
Race-Based Differences in ST-Segment–Elevation Myocardial Infarction Process Metrics and Mortality From 2015 Through 2021: An Analysis of 178 062 Patients From the American Heart Association Get With The Guidelines–Coronary Artery Disease Registry. Circulation. Published 17 July 2023. doi:10.1161/circulationaha.123.065512
Summarised from the published abstract; every number is checked against it