Moledina, SM, Shoaib, A ORCID: https://orcid.org/0000-0003-0513-8319, Weston, C, Aktaa, S, Gc Van Spall, H, Kassam, A, Kontopantelis, E, Banerjee, S, Rashid, M ORCID: https://orcid.org/0000-0001-9725-1583, Gale, CP and Mamas, MA ORCID: https://orcid.org/0000-0001-9241-8890 (2021) Ethnic disparities in care and outcomes of non-ST-segment elevation myocardial infarction: a nationwide cohort study. European Heart Journal - Quality of Care and Clinical Outcomes.

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Abstract

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.

Item Type: Article
Additional Information: The final version of this manuscript and all relevant information related to it, including copyrights, can be found online at; https://academic.oup.com/ehjqcco/advance-article/doi/10.1093/ehjqcco/qcab030/6248090
Subjects: R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Related URLs:
Depositing User: Symplectic
Date Deposited: 20 May 2021 14:29
Last Modified: 20 May 2021 14:29
URI: https://eprints.keele.ac.uk/id/eprint/9619

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