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 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." However, while black patients were more likely to use emergency medical services (49.1 percent vs. 45.2 percent), they had shorter median driving distances and drive times to a hospital, which was often larger and/or academic."

Regardless of socioeconomic factors or transportation logistics, the study found black patients with AMI experienced a 9 percent longer median time from symptom onset to presentation (114 minutes vs. 101 minutes).

"Despite significant advances in AMI care as well as the elaboration of quality improvement initiatives designed to reduce or eliminated discrepancies in care, racial differences in both short- and long-term outcomes persist," the authors conclude.

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: African Americans, African Continental Ancestry Group, Emergency Medical Services, European Continental Ancestry Group, Heart Failure, Quality Improvement, Registries, Shock, Cardiogenic, Single Person, Social Isolation, Questionnaires, National Cardiovascular Data Registries, ACTION Registry


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