TY - JOUR
T1 - Ethnic disparities in care and outcomes of non-ST-segment elevation myocardial infarction
T2 - a nationwide cohort study
AU - Moledina, Saadiq M
AU - Shoaib, Ahmad
AU - Weston, Clive
AU - Aktaa, Suleman
AU - Gc Van Spall, Harriette
AU - Kassam, Aliya
AU - Kontopantelis, Evangelos
AU - Banerjee, Shrilla
AU - Rashid, Muhammad
AU - Gale, Chris P
AU - Mamas, Mamas A
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions please email: [email protected].
PY - 2021/4/21
Y1 - 2021/4/21
N2 - BACKGROUND: Little is known about ethnic disparities in care and clinical outcomes of patients admitted with non-ST-segment elevation myocardial infarction (NSTEMI) in national cohorts from universal healthcare systems derived from Europe.METHODS & RESULTS: We identified 280,588 admissions with NSTEMI in the United Kingdom (UK) Myocardial Infarction National Audit Project (MINAP), 2010-2017, including White patients (n = 258,364) and Black, Asian and Minority Ethnic (BAME) patients (n = 22,194). BAME patients were younger (66 years vs. 73 years, P < 0.001) and more frequently had hypertension (66% vs 54%, P < 0.001), hypercholesterolemia (49% vs 34%, P < 0.001) and diabetes (48% vs 24%, P < 0.001). BAME patients more frequently received invasive coronary angiography (80% vs 68%, P < 0.001), percutaneous coronary intervention (PCI) (52% vs 43%, P < 0.001) and coronary artery bypass graft surgery (9% vs 7%, P < 0.001). Following propensity score matching, BAME compared with White patients had similar in-hospital all-cause mortality (OR:0.91, CI: 0.76-1.06, P = 0.23), major bleeding (OR: 0.99, CI: 0.75 - 1.25, P = 0.95), reinfarction (OR: 1.15, CI: 0.84 - 1.46, P = 0.34) and major adverse cardiovascular events (MACE) (OR:0.94, CI: 0.80-1.07, P = 0.35).CONCLUSION: BAME patients with NSTEMI had higher cardiometabolic risk profiles and were more likely to undergo invasive angiography and revascularization, with similar clinical outcomes as those of their White counterparts. Among the quality indicators assessed, there is no evidence of care disparities among BAME patients presenting with NSTEMI.
AB - BACKGROUND: Little is known about ethnic disparities in care and clinical outcomes of patients admitted with non-ST-segment elevation myocardial infarction (NSTEMI) in national cohorts from universal healthcare systems derived from Europe.METHODS & RESULTS: We identified 280,588 admissions with NSTEMI in the United Kingdom (UK) Myocardial Infarction National Audit Project (MINAP), 2010-2017, including White patients (n = 258,364) and Black, Asian and Minority Ethnic (BAME) patients (n = 22,194). BAME patients were younger (66 years vs. 73 years, P < 0.001) and more frequently had hypertension (66% vs 54%, P < 0.001), hypercholesterolemia (49% vs 34%, P < 0.001) and diabetes (48% vs 24%, P < 0.001). BAME patients more frequently received invasive coronary angiography (80% vs 68%, P < 0.001), percutaneous coronary intervention (PCI) (52% vs 43%, P < 0.001) and coronary artery bypass graft surgery (9% vs 7%, P < 0.001). Following propensity score matching, BAME compared with White patients had similar in-hospital all-cause mortality (OR:0.91, CI: 0.76-1.06, P = 0.23), major bleeding (OR: 0.99, CI: 0.75 - 1.25, P = 0.95), reinfarction (OR: 1.15, CI: 0.84 - 1.46, P = 0.34) and major adverse cardiovascular events (MACE) (OR:0.94, CI: 0.80-1.07, P = 0.35).CONCLUSION: BAME patients with NSTEMI had higher cardiometabolic risk profiles and were more likely to undergo invasive angiography and revascularization, with similar clinical outcomes as those of their White counterparts. Among the quality indicators assessed, there is no evidence of care disparities among BAME patients presenting with NSTEMI.
U2 - 10.1093/ehjqcco/qcab030
DO - 10.1093/ehjqcco/qcab030
M3 - Article
C2 - 33892502
SN - 2058-1742
JO - European heart journal. Quality of care & clinical outcomes
JF - European heart journal. Quality of care & clinical outcomes
ER -
