TY - JOUR
T1 - Regional differences in clinical profile, quality of care, and outcomes among Hispanic patients hospitalized with acute myocardial infarction in the Get with Guidelines-Coronary Artery Disease (GWTG-CAD) Registry
AU - Krim, Selim R.
AU - Vivo, Rey P.
AU - Krim, Nassim R.
AU - Cox, Margueritte
AU - Hernandez, Adrian F.
AU - Peterson, Eric D.
AU - Fonarow, Gregg C.
AU - Piña, Ileana L.
AU - Schwamm, Lee H.
AU - Bhatt, Deepak L.
N1 - Funding Information:
This study was supported in part by a Young Investigator database research seed grant from the Council of Clinical Cardiology of the American Heart Association (AHA). The GWTG-CAD program is provided by the AHA. The GWTG-CAD program is currently supported in part by Medtronic, Ortho-McNeil, and the AHA Pharmaceutical Roundtable. Dr Hernandez reports receiving research grants from Johnson & Johnson and honoraria from Medtronic, Amgen, and Astra Zeneca. Dr Peterson serves as the principal investigator of the Data Analytic Center for the GWTG of the AHA. He reports receiving research support from Bristol-Meyers Squibb, Sanofi, Merck, Schering-Plough, Lilly, and Johnson & Johnson. Dr Schwamm serves as the chair of the GWTG Steering Committee of the AHA. Dr Fonarow served as a former chair of the AHA GWTG Steering Committee. He reports receiving research grants from National Heart, Lung, and Blood Institute (significant); receiving honoraria from Medtronic (modest); and serving as a consultant for Novartis (significant). Dr. Bhatt reports receiving grants from Astra Zeneca, Bristol-Myers Squibb, Eisai, Sanofi Aventis, and The Medicines Company; he serves as the chair of the AHA GWTG Science Subcommittee. The remaining authors report no conflicts of interest.
PY - 2011/12
Y1 - 2011/12
N2 - Background: Although Hispanics constitute the largest minority in the United States, it is unknown whether regional differences in quality of care and outcomes exist among Hispanic patients hospitalized with acute myocardial infarction (MI). Methods: Using the GWTG-CAD Registry, clinical characteristics, conformity with quality measures, and in-hospital outcomes were assessed among Hispanic patients from different geographic regions admitted for acute MI in participating hospitals. Results: A total of 11,299 Hispanic patients treated for acute MI at 277 hospitals from 4 regions were included in the study. Midwestern Hispanics were more likely to be younger, with male predominance in all regions. Northeastern Hispanics were more often insured with Medicaid. All subgroups showed high rates of hypertension, dyslipidemia, diabetes, and smoking, with the highest rates observed in the northeast region. Northeastern Hispanics were more likely to be discharged on angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, β-blockers, and statin or other lipid-lowering therapy. No significant regional differences were observed in aspirin, clopidogrel, and guideline-recommended door-to-balloon and door-to-thrombolysis times. Although Hispanics in the south and northeast were more likely to have a longer hospital stay compared with the west, there were no regional differences in in-hospital mortality. Conclusions: Among Hispanics with acute MI enrolled in the GWTG-CAD program, there were modest regional differences in clinical profile; high rates of use and, with few exceptions, no regional differences in guideline-recommended therapies; and no regional variation in in-hospital mortality.
AB - Background: Although Hispanics constitute the largest minority in the United States, it is unknown whether regional differences in quality of care and outcomes exist among Hispanic patients hospitalized with acute myocardial infarction (MI). Methods: Using the GWTG-CAD Registry, clinical characteristics, conformity with quality measures, and in-hospital outcomes were assessed among Hispanic patients from different geographic regions admitted for acute MI in participating hospitals. Results: A total of 11,299 Hispanic patients treated for acute MI at 277 hospitals from 4 regions were included in the study. Midwestern Hispanics were more likely to be younger, with male predominance in all regions. Northeastern Hispanics were more often insured with Medicaid. All subgroups showed high rates of hypertension, dyslipidemia, diabetes, and smoking, with the highest rates observed in the northeast region. Northeastern Hispanics were more likely to be discharged on angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, β-blockers, and statin or other lipid-lowering therapy. No significant regional differences were observed in aspirin, clopidogrel, and guideline-recommended door-to-balloon and door-to-thrombolysis times. Although Hispanics in the south and northeast were more likely to have a longer hospital stay compared with the west, there were no regional differences in in-hospital mortality. Conclusions: Among Hispanics with acute MI enrolled in the GWTG-CAD program, there were modest regional differences in clinical profile; high rates of use and, with few exceptions, no regional differences in guideline-recommended therapies; and no regional variation in in-hospital mortality.
UR - http://www.scopus.com/inward/record.url?scp=82555168280&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=82555168280&partnerID=8YFLogxK
U2 - 10.1016/j.ahj.2011.09.006
DO - 10.1016/j.ahj.2011.09.006
M3 - Article
C2 - 22137071
AN - SCOPUS:82555168280
SN - 0002-8703
VL - 162
SP - 988-995.e4
JO - American heart journal
JF - American heart journal
IS - 6
ER -