Heart Attack Outcomes Vary By Ethnicity, Gender and Age

MedicalResearch.com Interview with:
Sahil Khera, MD and
Dhaval Kolte, MD, PhD
Department of Medicine, Division of Cardiology
New York Medical College, NY

Medical Research: What are the main findings of the study?

Answer: We used the publicly available Nationwide Inpatient Sample (NIS) databases for our study. We analyzed data on 6.5 million patients with heart attack (all types) from 2002 to 2011 in United States. Out of these 3.98 million were admitted with a diagnosis of non-ST elevation myocardial infarction (NSTEMI). Our objective was to describe how the care for patients with NSTEMI has changed over the past 10 years and whether this has resulted in better patient outcomes. We looked at the proportion of patients with NSTEMI who underwent cardiac catheterization each year. We also studied how many patients died in the hospital, how long was the hospital stay, and what was the total cost of hospitalization for this condition. Lastly, we determined if the changes in treatment and outcomes over the years were similar for different age- groups, men and women, and for different racial/ethnic groups.

In this analysis, we looked at cardiac catheterization trends after NSTEMI for both within 24 hours and within 48 hours. This is the first study of its kind to analyze two different time frames of early catheterization simultaneously. Although there was an increase in the proportion of patients with NSTEMI with increase in utilization of early cardiac catheterization and decrease in in-hospital death and length of stay, age-, sex-, and race/ethnicity-specific differences in the management and outcomes of NSTEMI were observed, and further studies are needed to develop strategies to ensure more equitable care for patients with this type of heart attack.

Medical Research: What should clinicians and patients take away from your report?  

Answer: There are significant differences in the age-, gender and ethnicity specific trends in management and outcomes of NSTEMI and these data should prompt further studies to explore the reasons for the differences and guide policy makers to ensure equitable care for patients of all ethnicities, gender and age.

Citation:

Non‐ST‐Elevation Myocardial Infarction in the United States: Contemporary Trends in Incidence, Utilization of the Early Invasive Strategy, and In‐Hospital Outcomes

Sahil Khera, Dhaval Kolte, Wilbert S. Aronow, Chandrasekar Palaniswamy, Kathir Selvan Subramanian, Taimoor Hashim, Marjan Mujib, Diwakar Jain, Rajiv Paudel, Ali Ahmed, William H. Frishman, Deepak L. Bhatt, Julio A. Panza, and Gregg C. Fonarow

J Am Heart Assoc. 2014;3:e000995, originally published August 1, 2014, doi:10.1161/JAHA.114.000995