Rural EMS STEMI Patients – Why the Delay to PCI?

The objective of this study is to identify patient and EMS agency factors associated with timely reperfusion of patients with ST-elevation myocardial infarction (STEMI). We conducted a cohort study of adult patients (≥18 years old) with STEMI activations from 2016 to 2020. Data was obtained from a regional STEMI registry, which included eight rural county EMS agencies and three North Carolina percutaneous coronary intervention (PCI) centers. On each patient, prehospital and in-hospital time intervals were abstracted. The primary outcome was the ability to achieve the 90-minute EMS FMC to PCI time goal (yes vs. no). We used generalized estimating equations accounting for within-agency clustering to evaluate the association between patient and agency factors and meeting first medical contact (FMC) to PCI time goal while accounting for clustering within the agency. Among 365 rural STEMI patients 30.1% were female (110/365) with a mean age of 62.5 ± 12.7 years. PCI was performed within the time goal in 60.5% (221/365) of encounters. The FMC to PCI time goal was met in 45.5% (50/110) of women vs 69.8% (178/255) of men (p  Nearly 40% of rural STEMI patients transported by EMS failed to receive FMC to PCI within 90 min. Women were less likely than men to receive reperfusion within the time goal, which represents an important health care disparity.</p

Demographic data for liver transplant recipients, based on <i>APOL1</i> genotype of African American deceased donors.

<p>Demographic data for liver transplant recipients, based on <i>APOL1</i> genotype of African American deceased donors.</p

Allograft function outcomes for liver transplant recipients, based on <i>APOL1</i> genotype of African American deceased donors.

<p>Allograft function outcomes for liver transplant recipients, based on <i>APOL1</i> genotype of African American deceased donors.</p

Allograft Survival Time with 0, 1, or 2 <i>APOL1</i> Renal Risk Variants in Donor Liver.

<p>The number of censored events is the difference between the number of transplantations that started the year and the number of events observed during the year. These numbers are shown in parentheses at the bottom of the plot; each color corresponds to a specific <i>APOL1</i> risk group. With a P-value of 0.6491 there is little correlation between liver allograft survival and the <i>APOL1</i> renal risk variants. P-value is from the fully adjusted Cox proportional model.</p

Additional file 2: Table S3. of Genome-wide association study of coronary artery calcified atherosclerotic plaque in African Americans with type 2 diabetes

Replication of AA-DHS admixture mapping results in JHS. (XLSX 11 kb

Additional file 3: Table S1. of Genome-wide association study of coronary artery calcified atherosclerotic plaque in African Americans with type 2 diabetes

List of SNPs with meta-analysis p-value less than 10–4. (XLSX 190 kb

Additional file 1: Table S4. of Genome-wide association study of coronary artery calcified atherosclerotic plaque in African Americans with type 2 diabetes

Meta-analysis of 130 HU CAC scores in AA-DHS and JHS. (XLSX 230 kb