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Racial and Ethnic Disparities in Management and Outcomes of Cardiac Arrest Complicating Acute Myocardial Infarction.
Subramaniam, Anna V; Patlolla, Sri Harsha; Cheungpasitporn, Wisit; Sundaragiri, Pranathi R; Miller, P Elliott; Barsness, Gregory W; Bell, Malcolm R; Holmes, David R; Vallabhajosyula, Saraschandra.
Afiliación
  • Subramaniam AV; Department of Medicine Mayo Clinic Rochester MN.
  • Patlolla SH; Department of Cardiovascular Surgery Mayo Clinic Rochester MN.
  • Cheungpasitporn W; Division of Nephrology and Hypertension Department of Medicine Mayo Clinic Rochester MN.
  • Sundaragiri PR; Division of Hospital Internal Medicine Department of Medicine Mayo Clinic Rochester MN.
  • Miller PE; Division of Cardiovascular Medicine Department of Medicine Yale University School of Medicine New Haven CT.
  • Barsness GW; Department of Cardiovascular Medicine Mayo Clinic Rochester MN.
  • Bell MR; Department of Cardiovascular Medicine Mayo Clinic Rochester MN.
  • Holmes DR; Department of Cardiovascular Medicine Mayo Clinic Rochester MN.
  • Vallabhajosyula S; Department of Cardiovascular Medicine Mayo Clinic Rochester MN.
J Am Heart Assoc ; 10(11): e019907, 2021 06.
Article en En | MEDLINE | ID: mdl-34013741
Background The role of race and ethnicity in the outcomes of cardiac arrest (CA) complicating acute myocardial infarction (AMI) is incompletely understood. Methods and Results This was a retrospective cohort study of adult admissions with AMI-CA from the National Inpatient Sample (2012-2017). Self-reported race/ethnicity was classified as White, Black, and others (Hispanic, Asian or Pacific Islander, Native American, Other). Outcomes of interest included in-hospital mortality, coronary angiography, percutaneous coronary intervention, palliative care consultation, do-not-resuscitate status use, hospitalization costs, hospital length of stay, and discharge disposition. Of the 3.5 million admissions with AMI, CA was noted in 182 750 (5.2%), with White, Black, and other races/ethnicities constituting 74.8%, 10.7%, and 14.5%, respectively. Black patients admitted with AMI-CA were more likely to be female, with more comorbidities, higher rates of non-ST-segment-elevation myocardial infarction, and higher neurological and renal failure. Admissions of patients of Black and other races/ethnicities underwent coronary angiography (61.9% versus 70.2% versus 73.1%) and percutaneous coronary intervention (44.6% versus 53.0% versus 58.1%) less frequently compared to patients of white race (p<0.001). Admissions of patients with AMI-CA had significantly higher unadjusted mortality (47.4% and 47.4%) as compared with White patients admitted (40.9%). In adjusted analyses, Black race was associated with lower in-hospital mortality (odds ratio [OR], 0.95; 95% CI, 0.91-0.99; P=0.007) whereas other races had higher in-hospital mortality (OR, 1.11; 95% CI, 1.08-1.15; P<0.001) compared with White race. Admissions of Black patients with AMI-CA had longer length of hospital stay, higher rates of palliative care consultation, less frequent do-not-resuscitate status use, and fewer discharges to home (all P<0.001). Conclusions Racial and ethnic minorities received less frequent guideline-directed procedures and had higher in-hospital mortality and worse outcomes in AMI-CA.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Etnicidad / Manejo de la Enfermedad / Grupos Raciales / Paro Cardíaco / Infarto del Miocardio Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Am Heart Assoc Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Etnicidad / Manejo de la Enfermedad / Grupos Raciales / Paro Cardíaco / Infarto del Miocardio Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Am Heart Assoc Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido