WEDNESDAY, July 6, 2022 (HealthDay News) — Despite overall improvements in treatment and outcomes for ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI), disparities persist in treatment and outcomes, according to a study published online June 21 in the Annals of Emergency Medicine.
Juan Carlos C. Montoy, M.D., Ph.D., from University of California, San Francisco, and colleagues assessed differences across sex and race in the treatment of and outcomes for STEMI and NSTEMI. The analysis included 159,068 STEMI and 294,068 NSTEMI presentations in California from 2005 to 2015.
The researchers found that the percentage of patients undergoing timely angiography increased for STEMI (50 percent for men and 35.7 percent for women in 2005 versus 76.7 and 66.8 percent, respectively, in 2015) and NSTEMI (45 percent for men and 33.1 percent for women in 2005 versus 56.3 and 45.9 percent, respectively, in 2015). At baseline, men had a 1.1 percentage point advantage for one-year STEMI survival, but during the study, survival increased for women compared with men by 0.3 percentage points per year. Timely STEMI angiography increased for all races during the study period, but differences persisted (46 percent for White patients versus 31.2 percent for Black patients in 2005; 75.2 percent for White patients versus 69.2 percent for Black patients in 2015).
“Despite these advances, the sex-specific treatment and outcome gaps were large and decreased minimally over this time period,” the authors write. “Differences in treatment and outcomes according to race and ethnicity varied somewhat and were particularly notable for a significant and increasing gap in the care of Black patients with NSTEMI.”