Document Detail


Ethnic minorities exhibit reduction in door-to-balloon time comparable to whites with a newly-implemented emergency physician activation protocol (Code-STEMI).
MedLine Citation:
PMID:  19805836     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Studies have shown significant differences in door-to-balloon times (D2B) for ethnic minority patients (minorities) undergoing angioplasty for ST-elevation myocardial infarction (STEMI) compared to white patients (white). In this study, we evaluated the D2B for these groups before and after modification of the emergency protocol for STEMI. METHODS: We compared D2B for 51 consecutive STEMIs during 2006, (serial activation protocol, SAP) with D2B times for 72 consecutive STEMI patients during 2007 when a "Code STEMI" (concurrent activation) protocol was instituted. Outcomes were D2B times in whites versus minorities, pre- and post-Code-STEMI, length of stay (LOS) and peak troponin I levels. RESULTS: The median D2B time in the SAP group was 113 (whites) vs. 122 (minorities) minutes (p = 0.324), as compared to 74 (whites) vs. 78 (minorities) minutes (p = 0.324) in the Code STEMI group. The D2B for both groups was significantly reduced (p < 0.0001) with the use of Code STEMI. The median peak troponin I in the SAP group was 97 ng/mL (whites) vs. 78 ng/mL (minorities) (p = 0.084), as compared to 54 ng/mL (whites) vs. 29 ng/mL (minorities) (p = 0.084) for the Code STEMI group. LOS was 4.88 days (whites) vs. 4.39 days (minorities) (p = 0.84) in the SAP group, as compared to 3.7 days (whites) vs. 3.4 days (minorities) (p = 0.84) for the Code STEMI group, a significant change (p = 0.012) for both groups. CONCLUSION: No ethnic disparity was observed in the mean D2B time, LOS and peak troponin I levels between whites and minorities; both groups demonstrated comparable improvement in all outcomes evaluated.
Authors:
Anthony Al-Dehneh; Rupen Parikh; Aiman Hamdan; Donna Konlian; Robert Faillace; Vincent A Debari; Edward Jimenez; Mahesh Bikkina
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  21     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-06     Completed Date:  2010-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  506-10     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Seton Hall University, St. Joseph's Regional Medical Center, Paterson, New Jersey 07503, USA.
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MeSH Terms
Descriptor/Qualifier:
African Americans / ethnology
Aged
Angioplasty, Balloon
Angioplasty, Transluminal, Percutaneous Coronary*
Asian Americans / ethnology
Electrocardiography
Emergency Medical Services / standards*
European Continental Ancestry Group / ethnology
Female
Health Services Accessibility / statistics & numerical data*
Hispanic Americans / ethnology
Humans
Length of Stay
Male
Middle Aged
Minority Groups / statistics & numerical data*
Myocardial Infarction / blood,  ethnology*,  therapy*
Outcome Assessment (Health Care)
Retrospective Studies
Time Factors
Troponin I / blood
Chemical
Reg. No./Substance:
0/Troponin I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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