000			04677nam a22005657a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a0002-9149
024			_aS0002-9149(24)00444-2 [pii]
040			_aOvid MEDLINE(R)
099			_a38906395
245			_aRacial Disparities in Outcomes of Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction Secondary to Spontaneous Coronary Artery Dissection.
251			_aAmerican Journal of Cardiology. 225:52-60, 2024 Jun 19.
252			_aAm J Cardiol. 225:52-60, 2024 Jun 19.
253			_aThe American journal of cardiology
260			_c2024
260			_fFY2024
260			_p2024 Jun 19
265			_saheadofprint
265			_tPublisher
266			_d2024-08-07
266			_z2024/06/21 19:28
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aSpontaneous coronary artery dissection (SCAD) is a rare cause of ST-segment elevation myocardial infarction (STEMI), predominantly affecting women. Because primary percutaneous coronary intervention (PPCI) is reserved for a select group of patients, vulnerable and minority patients may experience delays in appropriate management and adverse outcomes. We examined the racial differences in the outcomes for patients with SCAD who underwent PPCI for STEMI. Records of patients aged >=18 years who underwent PPCI for SCAD-related STEMI between 2016 and 2020 were identified from the National Inpatient Sample database. Clinical, socioeconomic, and hospital characteristics were compared between non-White and White patients. Weighted multivariate analysis assessed the association of race with inpatient mortality, length of stay (LOS), and hospitalization costs. The total weighted estimate of patients with SCAD-STEMI who underwent PPCI was 4,945, constituting 25% non-White patients. Non-White patients were younger (56 vs 60.7 years, p <0.001); had a higher prevalence of diabetes, acute renal failure, and obesity; and were more likely to be uninsured and be in the lowest income group. Inpatient mortality (7.7% vs 8.4%, p = 0.74) and hospitalization costs ( _34,213 vs _31,858, p = 0.27) were similar for non-White and White patients, and the adjusted analysis did not show any association between the patients' race and inpatient mortality (odds ratio 0.60, 95% confidence interval [CI] 0.32 to 1.13, p = 0.11) or hospitalization costs (beta [beta coefficient]: 215, 95% CI -4,193 to 4,623, p >0.90). Similarly, there was no association between the patients' race and LOS (incident rate ratio 1.20, 95% CI 1.00 to 1.45, p = 0.054). The weighted multivariate analysis showed that age; clinical co-morbidities such as diabetes, acute renal failure, valvular dysfunction, and obesity; low-income status; and hospitalization in the western region were associated with adverse outcomes. In conclusion, our study does not show any differences in inpatient mortality, LOS, and hospitalization costs between non-White and White patients who underwent PPCI for SCAD-related STEMI. Copyright © 2024 Elsevier Inc. All rights reserved.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
650			_zAutomated
651			_aMedStar Heart & Vascular Institute
651			_aMedStar Washington Hospital Center
656			_aAdvanced Cardiac Catheterization Research Fellowship
656			_aInterventional Cardiology Fellowship
656			_aMedStar Shah Medical Group
657			_aJournal Article
700			_aAbusnina, Waiel _bMWHC _cAdvanced Cardiac Catheterization Research Fellowship _dMBBCh
700			_aBen-Dor, Itsik _bMHVI
700			_aCase, Brian C _bMHVI
700			_aCellamare, Matteo _bMHVI
700			_aChandrika, Parul _bMSMG
700			_aChaturvedi, Abhishek _bMWHC _cAdvanced Cardiac Catheterization Research Fellowship _dMBBS
700			_aChitturi, Kalyan _bMWHC _cAdvanced Cardiac Catheterization Research Fellowship _dDO
700			_aGarcia-Garcia, Hector M _bMHVI
700			_aHaberman, Dan _bMWHC _cInterventional Cardiology Fellowship _dMD
700			_aHashim, Hayder _bMHVI
700			_aLupu, Lior _bMWHC _cInterventional Cardiology Fellowship _dMBA, MD
700			_aMerdler, Ilan _bMHVI
700			_aWaksman, Ron _bMHVI
700			_aZhang, Cheng _bMHVI
790			_aChaturvedi A, Garcia-Garcia HM, Cellamare M, Zhang C, Chandrika P, Abusnina W, Chitturi KR, Haberman D, Lupu L, Merdler I, Case BC, Hashim HD, Ben-Dor I, Waksman R
856			_uhttps://dx.doi.org/10.1016/j.amjcard.2024.06.018 _zhttps://dx.doi.org/10.1016/j.amjcard.2024.06.018
942			_cART _dArticle
999			_c14359 _d14359