Impact of socioeconomic status on guideline-recommended care for ST-elevation myocardial infarction in the United States

Abstract: Disparity in the quality of care for cardiovascular conditions as it relates to income level is well established. Our analysis of the publicly available data from the Department of Health and Human Services Hospital Compare initiative suggests that this problem also pertains to the management of acute myocardial infarction (AMI). Our analysis revealed a direct correlation between the income level and the proportion of patients meeting the ACC/AHA Guideline recommended door-to-balloon (D2B) time of 90 min or less and door-to-needle (D2N) time of 30 min or less, for primary PCI (PPCI) and fibrinolytic administration, respectively. More importantly, hospitals as a group fail to meet these guideline-recommended standards. Further work is needed in this area to better understand this disparity. [Copyright &y& Elsevier]