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Ethnic minorities exhibit reduction in door-to-balloon time comparable to whites with a newly-implemented emergency physician activation protocol (Code-STEMI).
J Invasive Cardiol. 2009 Oct; 21(10):506-10.JI

Abstract

BACKGROUND

Studies have shown significant differences in door-to-balloon times (D2B) for ethnic minority patients (minorities) undergoing angioplasty for ST-elevation myocardial infarction (STEMI) compared to white patients (white). In this study, we evaluated the D2B for these groups before and after modification of the emergency protocol for STEMI.

METHODS

We compared D2B for 51 consecutive STEMIs during 2006, (serial activation protocol, SAP) with D2B times for 72 consecutive STEMI patients during 2007 when a "Code STEMI" (concurrent activation) protocol was instituted. Outcomes were D2B times in whites versus minorities, pre- and post-Code-STEMI, length of stay (LOS) and peak troponin I levels.

RESULTS

The median D2B time in the SAP group was 113 (whites) vs. 122 (minorities) minutes (p = 0.324), as compared to 74 (whites) vs. 78 (minorities) minutes (p = 0.324) in the Code STEMI group. The D2B for both groups was significantly reduced (p < 0.0001) with the use of Code STEMI. The median peak troponin I in the SAP group was 97 ng/mL (whites) vs. 78 ng/mL (minorities) (p = 0.084), as compared to 54 ng/mL (whites) vs. 29 ng/mL (minorities) (p = 0.084) for the Code STEMI group. LOS was 4.88 days (whites) vs. 4.39 days (minorities) (p = 0.84) in the SAP group, as compared to 3.7 days (whites) vs. 3.4 days (minorities) (p = 0.84) for the Code STEMI group, a significant change (p = 0.012) for both groups.

CONCLUSION

No ethnic disparity was observed in the mean D2B time, LOS and peak troponin I levels between whites and minorities; both groups demonstrated comparable improvement in all outcomes evaluated.

Authors+Show Affiliations

Department of Cardiology, Seton Hall University, St. Joseph's Regional Medical Center, Paterson, New Jersey 07503, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19805836

Citation

Al-Dehneh, Anthony, et al. "Ethnic Minorities Exhibit Reduction in Door-to-balloon Time Comparable to Whites With a Newly-implemented Emergency Physician Activation Protocol (Code-STEMI)." The Journal of Invasive Cardiology, vol. 21, no. 10, 2009, pp. 506-10.
Al-Dehneh A, Parikh R, Hamdan A, et al. Ethnic minorities exhibit reduction in door-to-balloon time comparable to whites with a newly-implemented emergency physician activation protocol (Code-STEMI). J Invasive Cardiol. 2009;21(10):506-10.
Al-Dehneh, A., Parikh, R., Hamdan, A., Konlian, D., Faillace, R., Debari, V. A., Jimenez, E., & Bikkina, M. (2009). Ethnic minorities exhibit reduction in door-to-balloon time comparable to whites with a newly-implemented emergency physician activation protocol (Code-STEMI). The Journal of Invasive Cardiology, 21(10), 506-10.
Al-Dehneh A, et al. Ethnic Minorities Exhibit Reduction in Door-to-balloon Time Comparable to Whites With a Newly-implemented Emergency Physician Activation Protocol (Code-STEMI). J Invasive Cardiol. 2009;21(10):506-10. PubMed PMID: 19805836.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ethnic minorities exhibit reduction in door-to-balloon time comparable to whites with a newly-implemented emergency physician activation protocol (Code-STEMI). AU - Al-Dehneh,Anthony, AU - Parikh,Rupen, AU - Hamdan,Aiman, AU - Konlian,Donna, AU - Faillace,Robert, AU - Debari,Vincent A, AU - Jimenez,Edward, AU - Bikkina,Mahesh, PY - 2009/10/7/entrez PY - 2009/10/7/pubmed PY - 2010/2/2/medline SP - 506 EP - 10 JF - The Journal of invasive cardiology JO - J Invasive Cardiol VL - 21 IS - 10 N2 - BACKGROUND: Studies have shown significant differences in door-to-balloon times (D2B) for ethnic minority patients (minorities) undergoing angioplasty for ST-elevation myocardial infarction (STEMI) compared to white patients (white). In this study, we evaluated the D2B for these groups before and after modification of the emergency protocol for STEMI. METHODS: We compared D2B for 51 consecutive STEMIs during 2006, (serial activation protocol, SAP) with D2B times for 72 consecutive STEMI patients during 2007 when a "Code STEMI" (concurrent activation) protocol was instituted. Outcomes were D2B times in whites versus minorities, pre- and post-Code-STEMI, length of stay (LOS) and peak troponin I levels. RESULTS: The median D2B time in the SAP group was 113 (whites) vs. 122 (minorities) minutes (p = 0.324), as compared to 74 (whites) vs. 78 (minorities) minutes (p = 0.324) in the Code STEMI group. The D2B for both groups was significantly reduced (p < 0.0001) with the use of Code STEMI. The median peak troponin I in the SAP group was 97 ng/mL (whites) vs. 78 ng/mL (minorities) (p = 0.084), as compared to 54 ng/mL (whites) vs. 29 ng/mL (minorities) (p = 0.084) for the Code STEMI group. LOS was 4.88 days (whites) vs. 4.39 days (minorities) (p = 0.84) in the SAP group, as compared to 3.7 days (whites) vs. 3.4 days (minorities) (p = 0.84) for the Code STEMI group, a significant change (p = 0.012) for both groups. CONCLUSION: No ethnic disparity was observed in the mean D2B time, LOS and peak troponin I levels between whites and minorities; both groups demonstrated comparable improvement in all outcomes evaluated. SN - 1557-2501 UR - https://www.unboundmedicine.com/medline/citation/19805836/Ethnic_minorities_exhibit_reduction_in_door_to_balloon_time_comparable_to_whites_with_a_newly_implemented_emergency_physician_activation_protocol__Code_STEMI__ L2 - https://medlineplus.gov/heartattack.html DB - PRIME DP - Unbound Medicine ER -