Abstract 300: Race/Ethnicity Is Not Associated with Longer Door to Balloon Time or Increased Mortality in Patients Undergoing Primary PCI for STEMI: Findings from AHA-GWTG

Abstract

Introduction: In patients with ST-Elevation Myocardial Infarction (STEMI) treated with PCI, door to balloon time (DTB) of ≤ 90 minutes is associated with improved outcomes. We sought to compare DTB between patients of different race/ethnicity undergoing primary PCI in Get With The Guidelines (GWTG) hospitals. Methods: We analyzed the GWTG registry to identify patients treated with primary PCI for STEMI within 24 hours of presentation between 2005-2009. Patients treated with fibrinolytics, transferred to the hospital for PCI, or those missing DTB were excluded. Baseline demographics, median DTB, proportion of patients with DTB ≤ 90 minutes, and in-hospital mortality were compared between groups: White, African American, Hispanic. Results: Of the 7824 patients, 85% were White (n=6666), 8% were African American (n=607) and 7% were Hispanic (n=551). When compared with Whites and Hispanics, African American were younger but had higher rates of smoking, hypertension, renal disease, prior myocardial infarction, heart failure, or stroke. The Hispanic group had a higher proportion of patients with diabetes, hyperlipidemia, and no insurance. Median DTB times and the proportion of patients treated ≤ 90 minutes were similar between the three groups (Figure). In-hospital mortality was similar in the groups: white (3.8%), African American (3.0%), and Hispanic (3.8%); p=0.62. Conclusion: Within the context of a national quality improvement initiative, race/ethnicity was not associated with either DTB or in-hospital mortality among STEMI patients undergoing PCI. This suggests that programs such as GWTG may reduce race/ethnicity based disparities in the care of patients with STEMI.