Evidence map›Paper›PMID 34101211›Full record

ArticleClinical cardiology2021

Impact of regionalizing ST-elevation myocardial infarction care on sex differences in reperfusion times and clinical outcomes.

Erin Rayner-Hartley, Graham C Wong, Cassandra Fayowski, John A Cairns, Joel Singer, Terry Lee, Tara Sedlak, Karin H Humphries, Michele Perry-Arnesen, Martha Mackay and 1 more

Abstract read
In one paragraph

Article in Clinical cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Erin Rayner-HartleyDivision of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
Graham C WongDivision of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
Cassandra FayowskiDivision of General Internal Medicine, Western University, London, Ontario, Canada.
John A CairnsDivision of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
Joel SingerSchool of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Terry LeeCentre for Health Evaluation and Outcome Sciences (CHEOS), Providence Health Care Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.
Tara SedlakDivision of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
Karin H HumphriesDivision of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
Michele Perry-ArnesenRoyal Columbian Hospital, Division of Cardiology, Fraser Health Authority, Surrey, British Columbia, Canada.
Martha MackayCentre for Health Evaluation and Outcome Sciences (CHEOS), Providence Health Care Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.
Christopher B FordyceDivision of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.ORCID https://orcid.org/0000-0002-4050-1518

Funding

Vancouver Coastal Health Research Institute
6 · The paper itself

Abstract

backgroundWomen with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention historically experience worse in-hospital outcomes compared to men. HYPOTHESIS: Implementation of a regional STEMI system will reduce care gaps in reperfusion times and in-hospital outcomes between women and men.

methods1928 patients (413 women, 21.4%) presented with an acute STEMI between June 2007 and March 2016. The population was divided into an early cohort (n = 728 patients, 2007-May 2011), and a late cohort (n = 1200 patients, June 2011-2016). The primary endpoints evaluated were reperfusion times and in-hospital outcomes.

resultsCompared to men, women experienced significant delays in first medical contact (FMC) to arrival at the emergency room (26.0 vs. 22.0 min, p < 0.001) and FMC-to-device (109 vs. 101 min p = 0.001). Women had higher incidences of post-PCI heart failure and death compared to men (p < 0.05). Following multivariable adjustment, no mortality difference was observed for women versus men (adjusted OR; 0.82; 95% confidence interval [CI], 0.51-1.34; p = 0.433) or for early versus late cohorts (adjusted OR; 1.04; 95% CI, 0.68-1.60; p = 0.856).

conclusionFollowing STEMI regionalization, women continued to experience significantly longer reperfusion times, although there was no difference in adjusted mortality. These results highlight the ongoing disparity of STEMI care between women and men, and suggest that regionalization alone is insufficient to close sex-based care gaps.

Indexed as

Percutaneous Coronary InterventionST Elevation Myocardial InfarctionEmergency Service, HospitalFemaleHumansMaleMyocardial ReperfusionReperfusionSex CharacteristicsTreatment Outcomesex differencesST-elevation myocardial infarctionsystems implementation

Identifiers

PMID34101211
PMCPMC8364721

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.