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Huded CP, Dalton JE, Kumar A, et al. Relationship of Neighborhood Deprivation and Outcomes of a Comprehensive ST-Segment-Elevation Myocardial Infarction Protocol. J Am Heart Assoc. 2021;e024540doi: 10.1161/JAHA.121.024540.
Huded, C. P., Dalton, J. E., Kumar, A., Krieger, N. I., Kassis, N., Phelan, M., Kravitz, K., Reed, G. W., Krishnaswamy, A., Kapadia, S. R., & Khot, U. (2021). Relationship of Neighborhood Deprivation and Outcomes of a Comprehensive ST-Segment-Elevation Myocardial Infarction Protocol. Journal of the American Heart Association, e024540. https://doi.org/10.1161/JAHA.121.024540
Huded, Chetan P, et al. "Relationship of Neighborhood Deprivation and Outcomes of a Comprehensive ST-Segment-Elevation Myocardial Infarction Protocol." Journal of the American Heart Association vol. (2021): e024540. doi: https://doi.org/10.1161/JAHA.121.024540
Huded CP, Dalton JE, Kumar A, Krieger NI, Kassis N, Phelan M, Kravitz K, Reed GW, Krishnaswamy A, Kapadia SR, Khot U. Relationship of Neighborhood Deprivation and Outcomes of a Comprehensive ST-Segment-Elevation Myocardial Infarction Protocol. J Am Heart Assoc. 2021 Nov 15;e024540. doi: 10.1161/JAHA.121.024540. Epub 2021 Nov 15. PMID: 34779652.
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J Am Heart Assoc. 2021 Nov 15;e024540. doi: 10.1161/JAHA.121.024540. Epub 2021 Nov 15.

Relationship of Neighborhood Deprivation and Outcomes of a Comprehensive ST-Segment-Elevation Myocardial Infarction Protocol.

Journal of the American Heart Association

Chetan P Huded, Jarrod E Dalton, Anirudh Kumar, Nikolas I Krieger, Nicholas Kassis, Michael Phelan, Kathleen Kravitz, Grant W Reed, Amar Krishnaswamy, Samir R Kapadia, Umesh Khot

Affiliations

  1. Department of Cardiology Saint Luke's Mid-America Heart Institute Kansas City MO.
  2. Department of Quantitative Health Sciences Lerner Research InstituteCleveland Clinic Cleveland OH.
  3. Department of Cardiovascular Medicine Heart, Vascular, & Thoracic InstituteCleveland Clinic Cleveland OH.
  4. Center for Healthcare Delivery Innovation Heart, Vascular, & Thoracic InstituteCleveland Clinic Cleveland OH.
  5. Department of Emergency Medicine Emergency Services InstituteCleveland Clinic Cleveland OH.

PMID: 34779652 DOI: 10.1161/JAHA.121.024540

Abstract

Background We evaluated whether a comprehensive ST-segment-elevation myocardial infarction protocol (CSP) focusing on guideline-directed medical therapy, transradial percutaneous coronary intervention, and rapid door-to-balloon time improves process and outcome metrics in patients with moderate or high socioeconomic deprivation. Methods and Results A total of 1761 patients with ST-segment-elevation myocardial infarction treated with percutaneous coronary intervention at a single hospital before (January 1, 2011-July 14, 2014) and after (July 15, 2014- July 15, 2019) CSP implementation were included in an observational cohort study. Neighborhood deprivation was assessed by the Area Deprivation Index and was categorized as low (≤50th percentile; 29.0%), moderate (51st -90th percentile; 40.8%), and high (>90th percentile; 30.2%). The primary process outcome was door-to-balloon time. Achievement of guideline-recommend door-to-balloon time goals improved in all deprivation groups after CSP implementation (low, 67.8% before CSP versus 88.5% after CSP; moderate, 50.7% before CSP versus 77.6% after CSP; high, 65.5% before CSP versus 85.6% after CSP; all

Keywords: STEMI; disparities; door‐to‐balloon time; myocardial infarction; socioeconomic position

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