NCDR Study Shows Longer Delay Times Persist For Black AMI Patients

Black patients with acute myocardial infarction (AMI) continue to experience a longer delay in time to presentation compared to white patients, according to a study published April 15 in the American Journal of Cardiology. Amy Leigh Miller, MD, PhD, FACC, et al., looked at patient data from the ACC's ACTION Registry and socioeconomic and community information from the American Community Survey. Among the 346,499 AMI patients treated at 744 hospitals, 11 percent (38,875) were of the black race. Results showed that the black patient group was less likely to have STEMI as compared to the white patient group (37.7 percent vs. 42.8 percent), but more likely to experience signs of cardiogenic shock or heart failure once at the hospital (17.8 percent vs. 15 percent). In regards to socioeconomic factors, the authors found "black patients were more likely to reside in communities with higher proportions of single-person households, unmarried people, and high residence turnover, suggesting greater social isolation." Read more.


Does Gender Impact Contact-to-Device Time and Mortality in STEMI Patients?

Female patients with STEMI may experience longer contact-to-device times and have a higher in-hospital mortality rate compared to male patients with STEMI, according to a study published Jan. 11 in the Journal of the American Heart Association. Robert O. Roswell, MD, FACC, et al., used the ACC's ACTION Registry to analyze the outcomes of 102,515 STEMI patients at 760 sites from January 2007 to December 2014. Female STEMI patients only represented 27.2 percent of the study's population, but had a higher median age and incidence of comorbidities. They were also more likely to be enrolled in Medicare, alert EMS of their symptoms and arrive by ambulance. Results showed that only 67.5 percent of female patients achieved the target contact-to-device time (≤90 minutes) compared to 75.6 percent of male patients. Furthermore, female patients had longer total ischemic times (161 minutes vs. 145 minutes) and a higher in-hospital mortality rate (4.1 percent vs. 2.0 percent) compared to male STEMI patients. While improving patient education about the symptoms of an acute coronary syndrome is necessary to lessen symptom onset to contact time, the authors state that "further investigation is needed to mitigate the sex-specific circumstances that exacerbate the risk of mortality for female STEMI patients." Read more.

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