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. Issue 12 (24th September 2013)

• Record Type: Journal Article
• Authors: Cavender, Matthew A.; Rassi, Andrew N.; Fonarow, Gregg C.; Cannon, Christopher P.; Peacock, W. Frank; Laskey, Warren K.; Hernandez, Adrian F.; Peterson, Eric D.; Cox, Margueritte; Grau‐Sepulveda, Marie; Schwamm, Lee H.; Bhatt, Deepak L.
• Is Part Of: Clinical cardiology. Volume 36:Issue 12(2013:Dec.)
• Page Start: 749
• Page End: 756
• Publication Date: 2013-09-24
• Subjects: Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.22213
• Languages: English
• ISSNs: 0160-9289

Abstract

<abstract abstract-type="main" id="clc22213-abs-0001"> <title>Abstract</title> <sec id="clc22213-sec-0001" sec-type="section"> <title>Background</title> <p id="clc22213-para-0001">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).</p> </sec> <sec id="clc22213-sec-0002" sec-type="section"> <title>Hypothesis</title> <p>There may be differences in D2B time associated with race/ethnicity.</p> </sec> <sec id="clc22213-sec-0003" sec-type="section"> <title>Methods</title> <p id="clc22213-para-0002">We identified 7445 white (n = 6365), African American (n = 568), and Hispanic (n = 512) patients undergoing primary PCI.</p> </sec> <sec id="clc22213-sec-0004" sec-type="section"> <title>Results</title> <p id="clc22213-para-0003">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) (<italic>P</italic> = 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; <italic>P</italic> = 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; <italic>P</italic> = 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%, <italic>P</italic> = 0.62).</p> </sec> <sec id="clc22213-sec-0005" sec-type="section"> <title>Conclusions</title> <p id="clc22213-para-0004">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.</p> </sec> </abstract>