Aishwarya Vijay,Xiaoning Huang,Mark D Huffman,Namratha R Kandula,Donald M Lloyd-Jones,Powell O Jose,Eugene Yang,Abhinav Goyal,Sadiya S Khan,Nilay S Shah
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Sex-stratified logistic regression models were adjusted for age and clinical characteristics.\r\n\r\nRESULTS\r\nThere were 5691 Asian patients (1520 Asian Indian, 422 Chinese, 430 Filipino, 114 Japanese, 283 Korean, 553 Vietnamese, and 2369 other Asian) and 141 271 non-Hispanic White patients, overall 30% female, and mean age of 66.5 years. Relative to non-Hispanic White adults, among patients with ST-segment-elevation MI, door-to-ECG time ≤10 minutes was less likely in Asian Indian (adjusted odds ratio [aOR], 0.64 [95% CI, 0.50-0.82]), Chinese (aOR, 0.65 [95% CI, 0.46-0.93]), and Korean (aOR, 0.57 [95% CI, 0.33-0.97]) men and in other Asian women (aOR, 0.61 [95% CI, 0.41-0.90]). Door-to-balloon time ≤90 minutes was less likely in Asian Indian men (aOR, 0.71 [95% CI, 0.56-0.90]) and Filipina women (aOR, 0.48 [95% CI, 0.24-0.98]). In patients with ST-segment-elevation MI or non-ST-segment-elevation MI, optimal medical therapy for MI was less likely in Korean men (aOR, 0.65 [95% CI, 0.47-0.90]) and more likely in Asian Indian men (aOR, 1.22 [95% CI, 1.06-1.40]) and women (aOR, 1.32 [95% CI, 1.04-1.67]) and Filipina women (aOR, 1.84 [95% CI, 1.27-2.67]).\r\n\r\nCONCLUSIONS\r\nMI quality of care varies among US Asian patients with ST-segment-elevation MI and non-ST-segment-elevation MI. Quality improvement programs must identify and address the factors that result in suboptimal MI quality of care among US Asian patients.","PeriodicalId":10239,"journal":{"name":"Circulation: Cardiovascular Quality and Outcomes","volume":"16 1","pages":"e011097"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Myocardial Infarction Quality of Care and Outcomes in Asian Ethnic Groups in the United States.\",\"authors\":\"Aishwarya Vijay,Xiaoning Huang,Mark D Huffman,Namratha R Kandula,Donald M Lloyd-Jones,Powell O Jose,Eugene Yang,Abhinav Goyal,Sadiya S Khan,Nilay S Shah\",\"doi\":\"10.1161/circoutcomes.124.011097\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND\\r\\nNational-level differences in myocardial infarction (MI) quality of care among Asian patients in the United States are unclear. We assessed the quality of MI care in the 6 largest US Asian ethnic groups.\\r\\n\\r\\nMETHODS\\r\\nPatients aged ≥18 years with ST-segment-elevation MI or non-ST-segment-elevation MI in the Get With The Guidelines-Coronary Artery Disease registry (711 US hospitals, 2015-2021) were assessed. The odds of MI-related quality of care and process outcomes were evaluated in Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, and other Asian adults compared with non-Hispanic White adults. Sex-stratified logistic regression models were adjusted for age and clinical characteristics.\\r\\n\\r\\nRESULTS\\r\\nThere were 5691 Asian patients (1520 Asian Indian, 422 Chinese, 430 Filipino, 114 Japanese, 283 Korean, 553 Vietnamese, and 2369 other Asian) and 141 271 non-Hispanic White patients, overall 30% female, and mean age of 66.5 years. Relative to non-Hispanic White adults, among patients with ST-segment-elevation MI, door-to-ECG time ≤10 minutes was less likely in Asian Indian (adjusted odds ratio [aOR], 0.64 [95% CI, 0.50-0.82]), Chinese (aOR, 0.65 [95% CI, 0.46-0.93]), and Korean (aOR, 0.57 [95% CI, 0.33-0.97]) men and in other Asian women (aOR, 0.61 [95% CI, 0.41-0.90]). Door-to-balloon time ≤90 minutes was less likely in Asian Indian men (aOR, 0.71 [95% CI, 0.56-0.90]) and Filipina women (aOR, 0.48 [95% CI, 0.24-0.98]). In patients with ST-segment-elevation MI or non-ST-segment-elevation MI, optimal medical therapy for MI was less likely in Korean men (aOR, 0.65 [95% CI, 0.47-0.90]) and more likely in Asian Indian men (aOR, 1.22 [95% CI, 1.06-1.40]) and women (aOR, 1.32 [95% CI, 1.04-1.67]) and Filipina women (aOR, 1.84 [95% CI, 1.27-2.67]).\\r\\n\\r\\nCONCLUSIONS\\r\\nMI quality of care varies among US Asian patients with ST-segment-elevation MI and non-ST-segment-elevation MI. Quality improvement programs must identify and address the factors that result in suboptimal MI quality of care among US Asian patients.\",\"PeriodicalId\":10239,\"journal\":{\"name\":\"Circulation: Cardiovascular Quality and Outcomes\",\"volume\":\"16 1\",\"pages\":\"e011097\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Circulation: Cardiovascular Quality and Outcomes\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1161/circoutcomes.124.011097\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Circulation: Cardiovascular Quality and Outcomes","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1161/circoutcomes.124.011097","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景美国亚裔患者心肌梗死（MI）治疗质量的国家级差异尚不明确。我们评估了美国 6 大亚裔群体的心肌梗死护理质量。方法评估了《指南》-冠状动脉疾病登记（2015-2021 年，美国 711 家医院）中年龄≥18 岁、ST 段抬高型心肌梗死或非 ST 段抬高型心肌梗死患者。与非西班牙裔白人成人相比，评估了亚裔印度人、中国人、菲律宾人、日本人、韩国人、越南人和其他亚裔成人与心肌梗死相关的护理质量和流程结果的几率。结果共有 5691 名亚裔患者（1520 名亚裔印度人、422 名中国人、430 名菲律宾人、114 名日本人、283 名韩国人、553 名越南人和 2369 名其他亚裔人）和 141271 名非西班牙裔白人患者，其中女性患者占 30%，平均年龄为 66.5 岁。与非西班牙裔白人成人相比，在 ST 段抬高型心肌梗死患者中，印度裔亚裔患者的门到心电图时间≤10 分钟的可能性较小（调整后的几率比 [aOR]，0.64[95%CI，0.50-0.82]）、中国人（aOR，0.65[95%CI，0.46-0.93]）和韩国人（aOR，0.57[95%CI，0.33-0.97]）以及其他亚洲女性（aOR，0.61[95%CI，0.41-0.90]）。印度裔亚裔男性（aOR，0.71 [95% CI，0.56-0.90]）和菲律宾裔女性（aOR，0.48 [95% CI，0.24-0.98]）门到气球时间≤90 分钟的可能性较低。在 ST 段抬高型心肌梗死或非 ST 段抬高型心肌梗死患者中，韩国男性（aOR，0.65 [95% CI，0.47-0.90]）和印度亚洲男性（aOR，1.22 [95% CI，1.结论 ST 段抬高型心肌梗死和非 ST 段抬高型心肌梗死的美国亚裔患者的护理质量存在差异。质量改进计划必须找出并解决导致美国亚裔患者心肌梗死护理质量不达标的因素。
Myocardial Infarction Quality of Care and Outcomes in Asian Ethnic Groups in the United States.
BACKGROUND
National-level differences in myocardial infarction (MI) quality of care among Asian patients in the United States are unclear. We assessed the quality of MI care in the 6 largest US Asian ethnic groups.
METHODS
Patients aged ≥18 years with ST-segment-elevation MI or non-ST-segment-elevation MI in the Get With The Guidelines-Coronary Artery Disease registry (711 US hospitals, 2015-2021) were assessed. The odds of MI-related quality of care and process outcomes were evaluated in Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, and other Asian adults compared with non-Hispanic White adults. Sex-stratified logistic regression models were adjusted for age and clinical characteristics.
RESULTS
There were 5691 Asian patients (1520 Asian Indian, 422 Chinese, 430 Filipino, 114 Japanese, 283 Korean, 553 Vietnamese, and 2369 other Asian) and 141 271 non-Hispanic White patients, overall 30% female, and mean age of 66.5 years. Relative to non-Hispanic White adults, among patients with ST-segment-elevation MI, door-to-ECG time ≤10 minutes was less likely in Asian Indian (adjusted odds ratio [aOR], 0.64 [95% CI, 0.50-0.82]), Chinese (aOR, 0.65 [95% CI, 0.46-0.93]), and Korean (aOR, 0.57 [95% CI, 0.33-0.97]) men and in other Asian women (aOR, 0.61 [95% CI, 0.41-0.90]). Door-to-balloon time ≤90 minutes was less likely in Asian Indian men (aOR, 0.71 [95% CI, 0.56-0.90]) and Filipina women (aOR, 0.48 [95% CI, 0.24-0.98]). In patients with ST-segment-elevation MI or non-ST-segment-elevation MI, optimal medical therapy for MI was less likely in Korean men (aOR, 0.65 [95% CI, 0.47-0.90]) and more likely in Asian Indian men (aOR, 1.22 [95% CI, 1.06-1.40]) and women (aOR, 1.32 [95% CI, 1.04-1.67]) and Filipina women (aOR, 1.84 [95% CI, 1.27-2.67]).
CONCLUSIONS
MI quality of care varies among US Asian patients with ST-segment-elevation MI and non-ST-segment-elevation MI. Quality improvement programs must identify and address the factors that result in suboptimal MI quality of care among US Asian patients.
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