Heart Attack Treatment Timing Improves, But Inequities Remain

By Jonathan Springston, Editor, Relias Media

The rate of men and women who received timely treatment after a heart attack improved and mortality rates declined between 2005 and 2015, but women still are less likely to receive the appropriate care as quickly as men.

Researchers studied more than 450,000 records of patients who experienced an ST-elevation myocardial infarction (STEMI) or a non-STEMI (NSTEMI) from 2005 to 2015 in California hospitals. The authors defined timely access as treatment on the day of hospital admission (STEMI) and within three days of admission (NSTEMI).

In 2005, 50% of men and 35.7% of women underwent timely angiography after a STEMI (45% vs. 33.1% for NSTEMI). By 2015, that rate had improved to 76.7% for men after a STEMI, but just 66.8% for women (56.3% vs. 45.9% after NSTEMI). Gaps in care were pronounced across racial categories, too. Asian, Black, and Hispanic patients all were less likely to receive timely care vs. white patients.

“Some of the factors influencing this pronounced treatment gap are insurance status, hospital characteristics, and geography,” said Juan Carlos Montoy, MD, PhD, assistant professor at the University of California, San Francisco department of emergency medicine and lead study author. “But there are biases and social issues that challenge access to care and impact the treatment of women and patients of color with heart issues. These gaps should concern clinicians and patients because they can result in delayed care and lower the likelihood that some patients receive potentially lifesaving treatment.”

Another reason this is an important topic is missed STEMI treatment time frames can complicate emergency medicine malpractice defense. For more on this and related subjects, be sure to read the latest issues of Clinical Cardiology Alert.