ArticleJournal of the American College of Cardiology2022
Rural-Urban Disparities in Outcomes of Myocardial Infarction, Heart Failure, and Stroke in the United States.
Article in Journal of the American College of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 129 papers, 1 of them a synthesis that pooled it.
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Who cites it
129 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Care for Atrial Fibrillation and Outcomes in Rural Versus Urban Communities in the United States: A Systematic and Narrative Review.Journal of the American Heart Association · 2025Pooled it
- Tailoring multidomain intervention programs to reduce cognitive and physical decline in older adults: Examining rural-urban differences in a nationwide cluster-randomized controlled trial.The journal of prevention of Alzheimer's disease · 2025Trial
- Effect of Aficamten on Health Status Outcomes in Obstructive Hypertrophic Cardiomyopathy: Results From SEQUOIA-HCM.Journal of the American College of Cardiology · 2024Trial
- Full-field analysis indicates late reperfusion therapy broadens and mechanically smooths the borderzone during post-infarction inflammation.Acta biomaterialia · 2026Article
- Inpatient Outcomes and Complications After Left Atrial Appendage Occlusion in Rural Versus Urban Hospitals in the United States.Clinical cardiology · 2026Article
- Rural-urban disparities in cardiovascular and other competing risk of death among cancer patients.Journal of advanced research · 2026Article
- Pulmonary Embolism-Attributable Mortality in Patients With Heart Failure in the United States, 2010 to 2020.JACC. Advances · 2026Article
- Chronic Conditions and Mortality in Medicare Beneficiaries Before and After the COVID-19 Pandemic.JAMA network open · 2026Article
- Rural-Urban Differences in Hypertension Prevalence and Control in a Large Regional Health System Cohort.Journal of clinical medicine · 2026Article
- Pre-pandemic sub-national disparities in the disease burden of ischemic heart disease and stroke in France.BMC cardiovascular disorders · 2026Article
- Burden of 292 causes of death and life expectancy decomposition in Iran, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023.The Lancet. Global health · 2026Article
- Article
- Epidemiological Characteristics of Acute Coronary Syndrome Patients at Ogulin General Hospital over a Ten-Year Period.Journal of clinical medicine · 2026Article
- Remote Management of Patients With Heart Failure in Medically Underserved Areas.JACC. Advances · 2026Article
- Regional travel distance is not associated with operative mortality in acute type A aortic dissection.JTCVS open · 2026Article
- Income and Geographic Disparities in in-Hospital Mortality Following Cardiovascular Procedures: Evidence From the National Inpatient Sample, 2016-2022.Health services research · 2026Observational
- Distance and Likelihood of Cardiovascular Imaging Receipt Among Medicare Beneficiaries: Cardiovascular Imaging Deserts Among Medicare Beneficiaries.JACC. Cardiovascular imaging · 2026Article
- Telemedicine adoption in cardiology: Determinants and predictors identified using Bayesian Model Averaging and Machine Learning.PLOS digital health · 2026Article
- Cardiogenic shock and acute renal failure associated mortality trends in the United States: a retrospective analysis of death records from 1999 to 2023.BMC cardiovascular disorders · 2026Article
- Post-Intensive Care Fragmentation Among Rural Veterans: Transitions Between VA and Community Health Systems.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
69 more citing papers are in PubMed but not listed here.
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6 authors.
Funding
Abstract
backgroundU.S. policy efforts have focused on reducing rural-urban health inequities. However, it is unclear whether gaps in care and outcomes remain among older adults with acute cardiovascular conditions.
objectivesThis study aims to evaluate rural-urban differences in procedural care and mortality for acute myocardial infarction (AMI), heart failure (HF), and ischemic stroke.
methodsThis is a retrospective cross-sectional study of Medicare fee-for-service beneficiaries aged ≥65 years with acute cardiovascular conditions from 2016 to 2018. Cox proportional hazards models with random hospital intercepts were fit to examine the association of presenting to a rural (vs urban) hospital and 30- and 90-day patient-level mortality.
resultsThere were 2,182,903 Medicare patients hospitalized with AMI, HF, or ischemic stroke from 2016 to 2018. Patients with AMI were less likely to undergo cardiac catherization (49.7% vs 63.6%, P < 0.001), percutaneous coronary intervention (42.1% vs 45.7%, P < 0.001) or coronary artery bypass graft (9.0% vs 10.2%, P < 0.001) within 30 days at rural versus urban hospitals. Thrombolysis rates (3.1% vs 10.1%, P < 0.001) and endovascular therapy (1.8% vs 3.6%, P < 0.001) for ischemic stroke were lower at rural hospitals. After adjustment for demographics and clinical comorbidities, the 30-day mortality HR was significantly higher among patients presenting to rural hospitals for AMI (HR: 1.10, 95% CI: 1.08 to 1.12), HF (HR: 1.15; 95% CI: 1.13 to 1.16), and ischemic stroke (HR: 1.20; 95% CI: 1.18 to 1.22), with similar patterns at 90 days. These differences were most pronounced for the subset of critical access hospitals that serve remote, rural areas.
conclusionsClinical, public health, and policy efforts are needed to improve rural-urban gaps in care and outcomes for acute cardiovascular conditions.
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