Not all heart attack patients receive the same type of care, researchers find

Heart attacks, also known as acute myocardial infarctions, have been a leading cause of death in the United States. However, advancements in treatment methods have significantly reduced the number of deaths over the past two decades. Despite these improvements, not all patients receive the recommended treatment for heart attacks.

A recent study led by Charleen Hsuan, an associate professor of health policy and administration at Penn State, focused on disparities in treatment for Hispanic and non-Hispanic Black patients in Florida who suffered from a severe type of heart attack called ST-elevation myocardial infarction (STEMI). The study, published in JAMA Network Open, revealed that these patients were less likely to receive percutaneous coronary intervention (PCI), a crucial treatment for STEMI.

PCI is a minimally invasive procedure that helps improve blood flow to the heart by widening blocked or narrow arteries. Research has shown that PCI can reduce mortality in STEMI patients by approximately 30%. Clinical guidelines recommend that STEMI patients should receive PCI within 90 minutes if they arrive at a hospital with PCI capability, or within 120 minutes if they need to be transferred to another hospital.

The study analyzed data from 139,629 STEMI patients in Florida between 2011 and 2021. The research team found significant racial disparities in the emergency care process. Non-Hispanic Black patients were less likely to come to a PCI-capable hospital, receive PCI, or be transferred to another hospital for PCI compared to non-Hispanic white patients. Hispanic patients also experienced disparities in certain steps of the care process.

These findings suggest that policymakers and hospital administrators need to address these disparities to ensure that all patients receive the recommended care for heart attacks. The study emphasizes the importance of focusing on whether STEMI patients receive PCI when they arrive at a PCI-capable hospital and if they receive PCI at a transfer hospital if needed.

While the study was conducted in Florida and may not be generalized to the entire United States, the large population of the state indicates that millions of Americans could be affected by these disparities. Further research is needed to identify the underlying factors contributing to these disparities, which could include insurance differences, hospital availability, or geographic location.

This study is part of a broader research initiative led by Charleen Hsuan to examine the quality of transfer care nationwide. By addressing racial and ethnic disparities in emergency care, the goal is to improve the quality of care for all patients and ensure that everyone receives appropriate treatment for heart attacks.

Other authors from Penn State who contributed to the study include David J. Vanness, Haoyu Bi, and Jeannette Rogowski. The research sheds light on the importance of addressing disparities in emergency care and highlights the need for further investigation to close the gap and improve outcomes for all patients.