Author + information
- Andrew Stewart,
- Tigran Khachatryan,
- David Hamilton,
- Jonathan Evans,
- Daniel Amponsah,
- Eric Suh,
- Kenneth Jutzy,
- Islam Abudayyeh and
- Anthony Hilliard
Background: National guidelines recommend the utilization of a robust network for pre-hospital care of patients who experience chest pain and other relatable symptoms subsequently classified as ST elevation myocardial infarction (STEMI). Despite the widespread use of this network, little is known about the influence of economic, demographic, and sociological factors on the use of this system by the STEMI patient population.
Methods: In this retrospective study, we examined 766 patients who presented to a tertiary-care university medical center with STEMI between 2009 and 2015. Of this cohort, 529 presented directly to the medical center and were included in this study. A group of clinical variables including gender, race, ethnicity, religion, and language were collected from a comprehensive review of patient records. Two sample t-test, χ 2, ANOVA, and Fischer's exact test were utilized to assess the impact of these variables on time to presentation and mode of transportation.
Results: Patients who utilized emergency medical services (EMS) as their mode of transportation had a 64 minute shorter time to presentation from the onset of their symptoms compared to those who utilized self or family/friend for transportation (151 minutes, 95% CI 136 – 168 vs 216 minutes, 95% CI 158 – 294; p = 0.021). There was no significant difference in time to presentation between Whites and African Americans (155 minutes vs 157 minutes). However, there was a trend towards shorter time to presentation in Asians compared to Whites and African Americans (p = 0.059). No significant associations were found between sex, religion, ethnicity, or language on time to presentation or mode of transportation.
Conclusions: In our study, a significant difference in time to presentation was observed for STEMI patients who presented via EMS compared to those who used private transportation. Although race was not found to have a significant impact on time to presentation, there was a trend towards lower presentation time in the Asian population. Understanding the impact of patient demographics and socioeconomic status aides in detecting disparities in the utilization of EMS.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Traditional and Novel Factors Used to Assess the Risk of, and Used for the Treatment of, Coronary Artery Disease
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1126-349
- 2017 American College of Cardiology Foundation