Baseline characteristics, pharmacological and invasive management of BAME compared with white patients stratified according to pre-COVID-19 and COVID-19 pandemic periods from the MINAP registry
| Variables | Pre-COVID-19 whites n=56 270 | Pre-COVID-19 BAME n=6308 | P value | COVID-19 whites n=9305 | COVID-19 BAME n=1863 | P value |
| Age, years, median (IQR) | 70 (59–80) | 63 (53–75) | <0.001 | 69 (59–78) | 62 (52–73) | <0.001 |
| Male, n (%) | 37 524 (66.7) | 4566 (72.4) | <0.001 | 6315 (67.9) | 1368 (73.4) | <0.001 |
| BMI, median (IQR) | 27.4 (24.2–31.1) | 26.7 (24.0–30.0) | <0.001 | 27.6 (24.4–31.3) | 26.9 (24.1–30.0) | <0.001 |
| Presenting characteristics | ||||||
| Heart rate, bpm, median (IQR) | 77 (66–90) | 77 (66–90) | 0.841 | 77 (66–90) | 79 (67–91) | 0.070 |
| Systolic blood pressure, median (IQR) | 137 (119–156) | 136 (119–155) | 0.047 | 140 (121–159) | 137 (120–157) | 0.008 |
| Cardiac arrest, n (%) | 3918 (7.1) | 375 (6.1) | 0.003 | 537 (6.2) | 129 (7.6) | 0.041 |
| Clinical syndrome | <0.001 | 0.012 | ||||
| STEMI, n (%) | 18 413 (35.1) | 1673 (30.2) | 2790 (34.6%) | 608 (37.9%) | ||
| NSTEMI, n (%) | 34 099 (64.9) | 3869 (69.8) | 5264 (65.4%) | 996 (62.1%) | ||
| Creatinine µmol/L, median (IQR) | 84 (71–104) | 88 (73–113) | <0.001 | 83 (70–101) | 85 (71–105) | <0.001 |
| Killip class | <0.001 | <0.001 | ||||
| No heart failure, n (%) | 41 002 (81.0) | 4630 (79.6) | 6582 (83.6) | 1343 (84.4) | ||
| Basal crepitation, n (%) | 6122 (12.1) | 641 (11.0) | 828 (10.5) | 120 (7.5) | ||
| Pulmonary oedema, n (%) | 2175 (4.3) | 382 (6.6) | 274 (3.5) | 74 (4.6) | ||
| Cardiogenic shock, n (%) | 1306 (2.6) | 167 (2.9) | 188 (2.4) | 55 (3.5) | ||
| LV systolic function | <0.001 | <0.001 | ||||
| Good, n (%) | 19 309 (41.7) | 2697 (49.5) | 3161 (43.7) | 754 (47.5) | ||
| Moderate, n (%) | 11 652 (25.2) | 1265 (23.2) | 1761 (24.4) | 411 (25.9) | ||
| Poor, n (%) | 4093 (8.8) | 450 (8.3) | 613 (8.5%) | 121 (7.6) | ||
| Not assessed, n (%) | 11 241 (24.3) | 1032 (19.0) | 1697 (23.5) | 303 (19.1) | ||
| Previous medical history | ||||||
| Percutaneous coronary intervention, n (%) | 7691 (15.1) | 1354 (23.4) | <0.001 | 1372 (17.1) | 339 (20.2) | 0.003 |
| Coronary artery bypass graft, n (%) | 3648 (7.1) | 589 (10.2) | <0.001 | 556 (7.0) | 112 (6.7) | 0.686 |
| Heart failure, n (%) | 3848 (7.5) | 493 (8.6) | 0.003 | 593 (7.5) | 107 (6.6) | 0.213 |
| Hypercholesterolaemia, n (%) | 16 098 (31.5) | 2733 (47.6) | <0.001 | 2482 (31.1) | 676 (41.4) | <0.001 |
| Angina, n (%) | 11 402 (22.2) | 1539 (27.1) | <0.001 | 1610 (20.3) | 341 (21.1) | 0.472 |
| Cerebrovascular disease, n (%) | 4393 (8.6) | 464 (8.1) | 0.252 | 654 (8.2) | 136 (8.2) | 0.972 |
| Myocardial infarction, n (%) | 12 144 (23.5) | 1778 (30.7) | <0.001 | 1919 (23.8) | 395 (23.6) | 0.874 |
| Peripheral vascular disease, n (%) | 2528 (4.9) | 207 (3.6) | <0.001 | 399 (5.0) | 48 (2.9) | <0.001 |
| Chronic kidney disease, n (%) | 3664 (7.2) | 746 (13.0) | <0.001 | 588 (7.3) | 157 (9.6) | <0.001 |
| Diabetes | <0.001 | <0.001 | ||||
| Not diabetic, n (%) | 41 749 (76.1) | 3077 (50.3) | 6351 (75.3) | 1078 (61.2) | ||
| Diet controlled, n (%) | 2265 (4.1) | 285 (4.7) | 379 (4.5) | 79 (4.5) | ||
| Oral medications, n (%) | 6879 (12.5) | 1805 (29.5) | 1091 (12.9) | 390 (22.1) | ||
| Insulin therapy, n (%) | 3979 (7.3) | 948 (15.5) | 611 (7.2) | 214 (12.2) | ||
| Hypertension, n (%) | 27 142 (52.2) | 3871 (66.0) | <0.001 | 6351 (75.3) | 1078 (61.2) | <0.001 |
| Smoking status | <0.001 | <0.001 | ||||
| Never smoked, n (%) | 15 205 (32.9) | 2630 (54.6) | 2434 (33.9) | 683 (47.6) | ||
| Previous smoker, n (%) | 17 917 (38.8) | 1017 (21.1) | 2670 (37.2) | 332 (23.1) | ||
| Current smoker, n (%) | 13 057 (28.3) | 1172 (24.3) | 2071 (28.9) | 421 (29.3) | ||
| Asthma/COPD, n (%) | 9155 (17.8) | 790 (13.8) | <0.001 | 1477 (18.7) | 211 (13.1) | <0.001 |
| Family history of CHD, n (%) | 12 021 (27.4) | 1240 (28.4) | 0.192 | 1919 (28.3) | 394 (27.1) | 0.342 |
| In-hospital pharmacology | ||||||
| Low molecular weight heparin, n (%) | 18 365 (41.3) | 1686 (38.5) | <0.001 | 2626 (39.9) | 473 (37.6) | 0.131 |
| Unfractionated heparin, n (%) | 12 933 (29.1) | 996 (22.9) | <0.001 | 2031 (30.2) | 378 (29.8) | 0.802 |
| Warfarin, n (%) | 1901 (4.3) | 127 (2.9) | <0.001 | 237 (3.6) | 28 (2.2) | 0.014 |
| Loop diuretic, n (%) | 10 948 (24.6) | 1153 (26.3) | 0.012 | 1490 (22.5) | 299 (23.5) | 0.485 |
| Glycoprotein IIbIIIa inhibitor use, n (%) | 2802 (6.2) | 344 (7.4) | <0.001 | 527 (7.9) | 111 (8.7) | 0.321 |
| Processes of care and outcomes | ||||||
| Seen by cardiologist, n (%) | 54 057 (97.0) | 6047 (97.1) | 0.667 | 8415 (96.8) | 1744 (96.5) | 0.564 |
| Percutaneous coronary intervention, n (%) | 26 075 (62.1) | 2794 (54.7) | <0.001 | 4571 (67.2) | 750 (61.5) | <0.001 |
| Time to reperfusion for STEMI, hours, median IQR | 3.6 (2.3–7.4) | 3.3 (2.4–6.0) | <0.001 | 3.7 (2.5–8.2) | 4.2 (2.5–7.2) | <0.001 |
| Call for help, hours, median (IQR) | 1.34 (0.4–4.9) | 1.52 (0.4–5.7) | <0.001 | 1.4 (0.5–5.5) | 1.7 (0.5–6.8) | 0.001 |
| Coronary angiography in NSTEMI, n (%) | 25 548 (85.9) | 3137 (84.3) | 0.095 | 4478 (90.0) | 758 (85.1) | <0.001 |
| Time to coronary angiography, hours, median (IQR) | 41.0 (4.33–89.3) | 46.7 (10.9–95.8) | <0.001 | 27.0 (2.65–69.5) | 39.6 (3.4–87.6) | <0.001 |
| P2Y12 use, n (%) | 41 050 (78.2) | 4404 (78.8) | 0.281 | 6069 (78.2) | 1123 (75.1) | <0.001 |
| Dual antiplatelet medication, n (%) | 30 527 (72.7) | 3437 (74.4) | 0.002 | 4617 (73.2) | 878 (70.2) | 0.032 |
| ACE inhibitors, n (%) | 31 589 (69.6) | 3205 (71.5) | 0.008 | 4889 (72.0) | 967 (73.6) | 0.251 |
| In-hospital mortality, n (%) | 3154 (5.9) | 283 (4.8) | <0.001 | 441 (5.2) | 117 (6.7) | <0.001 |
| 7-day mortality, n (%) | 4415 (8.3) | 385 (8.0) | <0.001 | 568 (6.7) | 143 (8.2) | 0.026 |
BAME, black, Asian and minority ethnic; BMI, body mass index; bpm, beats per minute; CHD, coronary heart disease; COPD, chronic obstructive pulmonary disease; LV, left ventricle; MINAP, Myocardial Ischaemia National Audit Project; NSTEMI, non-ST-elevation myocardial infarction; P2Y12, purinergic receptor inhibitor; STEMI, ST-elevation myocardial infarction.