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
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
Methodological detailsregistry analysis, multivariable-adjusted, analysed separately in women and men
- Registry analysis
- Multivariable-adjusted
- Analysed separately in women and men
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, womenHispanic Whitevs Non-Hispanic WhiteWomen | 1.39 (1.12–1.72) | |
| Adjusted in-hospital mortality, womenBlackvs Non-Hispanic WhiteWomen | 0.88 (0.74–1.03) | |
| Adjusted in-hospital mortality, menHispanic Whitevs Non-Hispanic WhiteMen | 0.99 (0.82–1.18) | |
| Adjusted in-hospital mortality, menBlackvs Non-Hispanic WhiteMen | 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.
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