Racial disparity in clinical outcomes following primary percutaneous coronary intervention for ST elevation myocardial infarction: influence of process of care
| Autor: | Darren K. McGuire, Sabina A. Murphy, James deLemos, Ellen C. Keeley, Shailja V. Parikh, Joshua A. Jacobi |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction White People Coronary artery disease Electrocardiography Reperfusion therapy Risk Factors Social Justice Internal medicine medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Angioplasty Balloon Coronary Socioeconomic status Retrospective Studies Asian business.industry Mortality rate Therapeutic effect Process Assessment Health Care Percutaneous coronary intervention Thrombolysis Hispanic or Latino Middle Aged medicine.disease Texas Black or African American surgical procedures operative Treatment Outcome Socioeconomic Factors Conventional PCI Acute Disease Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of interventional cardiology. 20(3) |
| ISSN: | 0896-4327 |
| Popis: | Previous studies have shown that compared with white patients, non-white patients with ST elevation myocardial infarction (STEMI) have worse clinical outcomes. Differences in co-morbidities, extent and severity of coronary artery disease, health insurance, and socioeconomic status have been identified as possible reasons for this disparity. However, an alternative explanation for such observed disparities in outcomes could be differences in process of care. For example, in most of these studies, non-white patients were less likely to receive reperfusion therapy, and if treated, were more likely to receive thrombolysis than to undergo primary percutaneous coronary intervention (PCI). We hypothesized that if all patients were treated similarly with primary PCI, there would be no difference in clinical outcomes. We analyzed the demographic, angiographic, in-hospital clinical outcomes, and long-term mortality rates of a racially diverse group of patients presenting to the same hospital with STEMI, all of whom were treated with primary PCI. Our data demonstrate that compared with white patients, non-white patients with STEMI who undergo primary PCI have similar in-hospital clinical outcomes and one-year mortality. This suggests that the previously observed differences in mortality rates may be, at least in part, attributable to differences in the process of care, and not solely to differences in patient factors or differential therapeutic effects. |
| Databáze: | OpenAIRE |
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