Outcome of hispanic patients treated with thrombolytic therapy for acute myocardial infarction

Results from the GUSTO-I and -III trials

Mauricio G Cohen, Christopher B. Granger, E. Magnus Ohman, Amanda L. Stebbins, Liliana R. Grinfeld, Arturo M. Cagide, Marcelo V. Elizari, Amadeo Betriu, David F. Kong, Eric J. Topol, Robert M. Califf

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

OBJECTIVES: We sought to describe the differences in the process of care and clinical outcomes between Hispanics and non- Hispanics receiving thrombolytic therapy for myocardial infarction (MI). BACKGROUND: Hispanics are the fastest growing and second largest minority in the U.S. but most cardiovascular disease data on Hispanics has been derived from retrospective studies and vital statistics. Despite their higher cardiovascular risk-factor profile, better outcomes after MI have been reported in Hispanics. METHODS: We studied the baseline characteristics, resource use and outcomes of 734 Hispanics and 27,054 non- Hispanics treated for MI in the GUSTO-I and -III trials. The primary end point of both trials was 30-day mortality. RESULTS: Hispanics were younger, shorter, lighter and more often diabetic and began thrombolysis 9 min later, compared with non-Hispanics. Measures of socioeconomic status (educational level, employment and health insurance) were lower among Hispanics. Fewer Hispanics than non-Hispanics underwent in-hospital angiography (70% vs. 74%, p = 0.013) or bypass surgery (11% vs. 13.5%, p = 0.04). Hispanics received more angiotensin-converting enzyme (ACE) inhibitors and less calcium-channel blockers, prophylactic lidocaine and inotropic agents. Mortality at 30 days and at one year did not differ significantly between Hispanics and non- Hispanics (6.4% vs. 6.7% and 9.0% vs. 9.7%, respectively). We noted no interactions between thrombolytic strategy and Hispanic status on major outcomes (30-day death, stroke and major bleeding). CONCLUSIONS: The care of Hispanics with MI differed slightly from that of non-Hispanics. Nevertheless, these differences in care did not affect long-term outcomes.

Original languageEnglish
Pages (from-to)1729-1737
Number of pages9
JournalJournal of the American College of Cardiology
Volume34
Issue number6
DOIs
StatePublished - Nov 15 1999
Externally publishedYes

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Thrombolytic Therapy
Hispanic Americans
Myocardial Infarction
Vital Statistics
Mortality
Calcium Channel Blockers
Health Insurance
Lidocaine
Angiotensin-Converting Enzyme Inhibitors
Social Class
Health Status

ASJC Scopus subject areas

  • Nursing(all)

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Outcome of hispanic patients treated with thrombolytic therapy for acute myocardial infarction : Results from the GUSTO-I and -III trials. / Cohen, Mauricio G; Granger, Christopher B.; Ohman, E. Magnus; Stebbins, Amanda L.; Grinfeld, Liliana R.; Cagide, Arturo M.; Elizari, Marcelo V.; Betriu, Amadeo; Kong, David F.; Topol, Eric J.; Califf, Robert M.

In: Journal of the American College of Cardiology, Vol. 34, No. 6, 15.11.1999, p. 1729-1737.

Research output: Contribution to journalArticle

Cohen, MG, Granger, CB, Ohman, EM, Stebbins, AL, Grinfeld, LR, Cagide, AM, Elizari, MV, Betriu, A, Kong, DF, Topol, EJ & Califf, RM 1999, 'Outcome of hispanic patients treated with thrombolytic therapy for acute myocardial infarction: Results from the GUSTO-I and -III trials', Journal of the American College of Cardiology, vol. 34, no. 6, pp. 1729-1737. https://doi.org/10.1016/S0735-1097(99)00433-7
Cohen, Mauricio G ; Granger, Christopher B. ; Ohman, E. Magnus ; Stebbins, Amanda L. ; Grinfeld, Liliana R. ; Cagide, Arturo M. ; Elizari, Marcelo V. ; Betriu, Amadeo ; Kong, David F. ; Topol, Eric J. ; Califf, Robert M. / Outcome of hispanic patients treated with thrombolytic therapy for acute myocardial infarction : Results from the GUSTO-I and -III trials. In: Journal of the American College of Cardiology. 1999 ; Vol. 34, No. 6. pp. 1729-1737.
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abstract = "OBJECTIVES: We sought to describe the differences in the process of care and clinical outcomes between Hispanics and non- Hispanics receiving thrombolytic therapy for myocardial infarction (MI). BACKGROUND: Hispanics are the fastest growing and second largest minority in the U.S. but most cardiovascular disease data on Hispanics has been derived from retrospective studies and vital statistics. Despite their higher cardiovascular risk-factor profile, better outcomes after MI have been reported in Hispanics. METHODS: We studied the baseline characteristics, resource use and outcomes of 734 Hispanics and 27,054 non- Hispanics treated for MI in the GUSTO-I and -III trials. The primary end point of both trials was 30-day mortality. RESULTS: Hispanics were younger, shorter, lighter and more often diabetic and began thrombolysis 9 min later, compared with non-Hispanics. Measures of socioeconomic status (educational level, employment and health insurance) were lower among Hispanics. Fewer Hispanics than non-Hispanics underwent in-hospital angiography (70{\%} vs. 74{\%}, p = 0.013) or bypass surgery (11{\%} vs. 13.5{\%}, p = 0.04). Hispanics received more angiotensin-converting enzyme (ACE) inhibitors and less calcium-channel blockers, prophylactic lidocaine and inotropic agents. Mortality at 30 days and at one year did not differ significantly between Hispanics and non- Hispanics (6.4{\%} vs. 6.7{\%} and 9.0{\%} vs. 9.7{\%}, respectively). We noted no interactions between thrombolytic strategy and Hispanic status on major outcomes (30-day death, stroke and major bleeding). CONCLUSIONS: The care of Hispanics with MI differed slightly from that of non-Hispanics. Nevertheless, these differences in care did not affect long-term outcomes.",
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AU - Granger, Christopher B.

AU - Ohman, E. Magnus

AU - Stebbins, Amanda L.

AU - Grinfeld, Liliana R.

AU - Cagide, Arturo M.

AU - Elizari, Marcelo V.

AU - Betriu, Amadeo

AU - Kong, David F.

AU - Topol, Eric J.

AU - Califf, Robert M.

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