RT Journal Article
SR Electronic
T1 Racial differences in management and outcomes of acute myocardial infarction during COVID-19 pandemic
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 734
OP 740
DO 10.1136/heartjnl-2020-318356
VO 107
IS 9
A1 Muhammad Rashid
A1 Adam Timmis
A1 Tim Kinnaird
A1 Nick Curzen
A1 Azfar Zaman
A1 Ahmad Shoaib
A1 Mohamed O Mohamed
A1 Mark A de Belder
A1 John Deanfield
A1 Glen Philip Martin
A1 Jianhua Wu
A1 Chris P Gale
A1 Mamas Mamas
YR 2021
UL http://heart.bmj.com/content/107/9/734.abstract
AB Objective There are concerns that healthcare and outcomes of black, Asian and minority ethnic (BAME) communities are disproportionately impacted by the COVID-19 pandemic. We investigated admission rates, treatment and mortality of BAME with acute myocardial infarction (AMI) during COVID-19.Methods Using multisource national healthcare records, patients hospitalised with AMI in England during 1 February–27 May 2020 were included in the COVID-19 group, whereas patients admitted during the same period in the previous three consecutive years were included in a pre-COVID-19 group. Multilevel hierarchical regression analyses were used to quantify the changes in-hospital and 7-day mortality in BAME compared with whites.Results Of 73 746 patients, higher proportions of BAME patients (16.7% vs 10.1%) were hospitalised with AMI during the COVID-19 period compared with pre-COVID-19. BAME patients admitted during the COVID-19 period were younger, male and likely to present with ST-elevation acute myocardial infarction. COVID-19 BAME group admitted with non-ST-elevation acute myocardial infarction less frequently received coronary angiography (86.1% vs 90.0%, p<0.001) and had a longer median delay to reperfusion (4.1 hours vs 3.7 hours, p<0.001) compared with whites. BAME had higher in-hospital (OR 1.68, 95% CI 1.27 to 2.28) and 7-day mortality (OR 1.81 95% CI 1.31 to 2.19) during COVID-19 compared with pre-COVID-19 period.Conclusion In this multisource linked cohort study, compared with whites, BAME patients had proportionally higher hospitalisation rates with AMI, less frequently received guidelines indicated care and had higher early mortality during COVID-19 period compared with pre-COVID-19 period. There is a need to develop clinical pathways to achieve equity in the management of these vulnerable populations.Data may be obtained from a third party (National Institute of Cardiovascular Outcome Research) and are not publicly available.