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Hispanics are one of the largest growing ethnic minorities in the United States but have been under represented in contemporary cardiovascular trials. Information regarding Hispanic patients treated with Primary PCI within a regional STEMI system of care has not been previously reported.
The Los Angeles County Emergency Medical System (EMS) STEMI Receiving Center (SRC) Database was queried from January 2007 to December 2011 to identify all patients with a pre-hospital ECG showing STEMI. Eight thousand, eight hundred and thirty-seven patients were included; 1,737 (19.7%) were Hispanic and 4,637 (52.5%) were non-Hispanic whites. Hispanic and non-Hispanic whites undergoing primary PCI were compared based upon demographics, treatment time intervals and in-hospital clinical outcome.
Hispanic patients were younger compared to non-Hispanic whites, 62.8 vs 67.5 years, p <0.0001, respectively. Treatment times including medical contact to door time (21 ± 12.9 vs 20.7 ± 12.2 mins, p= 0.43) and door to balloon time (63.1 ± 31.7 vs 63.9 ± 33.1 mins, p= 0.20) were similar between the Hispanic and non-Hispanic whites, respectively. Hispanic patients achieved a higher rate of TIMI 3 flow in the infarct related artery compared to non-Hispanic whites, 86.7% vs 83.7%, p = 0.04, respectively. The rate of vascular complications, need for emergent coronary artery bypass surgery, occurrence of stroke, length of hospital stay and in-hospital mortality were similar between the groups (Table).
Treatment times and clinical outcome were similar between Hispanic and non-Hispanic whites. These findings suggest that ethnic disparities to cardiovascular care can be overcome using an integrated regional STEMI system.
|Outcome||Hispanic(n=1737)||Non-Hispanic whites (n=4637)||p value|
|Emergency coronary artery bypass surgery||1.3||0.8||0.19|
|Length of stay, days||5.0 +/- 1.1||4.8 +/- 4.3||0.31|