• Matthew A Cavender, Andrew N Rassi, Gregg C Fonarow, Christopher P Cannon, W Frank Peacock, Warren K Laskey, Adrian F Hernandez, Eric D Peterson, Margueritte Cox, Marie Grau-Sepulveda, Lee H Schwamm, and Deepak L Bhatt.
• Department of Medicine, TIMI Study Group, Brigham and Women's Hospital and Harvard Medical School Boston, Massachusetts.
• Clin Cardiol. 2013 Dec 1; 36 (12): 749-56.

BackgroundPrior studies have described racial/ethnic disparities in door-to-balloon (DTB) time for patients undergoing primary percutaneous coronary intervention (PCI). We sought to compare DTB time between different racial/ethnic groups undergoing primary PCI for ST-elevation myocardial infarction in Get With the Guidelines (GWTG).HypothesisThere may be differences in D2B time associated with race/ethnicity.MethodsWe identified 7445 white (n = 6365), African American (n = 568), and Hispanic (n = 512) patients undergoing primary PCI.ResultsThere were no differences in the median DTB time between white (74 minutes; intraquartile range [IQR], 54-99), African American (77 minutes; IQR, 57-100), and Hispanic (75 minutes; IQR, 56-100) (P = 0.13) patients. There were no crude differences in DTB time ≤90 minutes; however, after adjusting for confounders, African American race was associated with lower odds of DTB time ≤90 minutes (odds ratio [OR]: 0.84; 95% confidence interval [CI]: 0.70-0.99; P = 0.04). This association was seen in African American males (OR: 0.66; 95% CI: 0.55-0.80) but not African American females (OR: 1.27; 95% CI: 0.96-1.68). Overall, Hispanic ethnicity was not associated with a difference in DTB time ≤90 minutes (OR: 0.98; 95% CI: 0.77-1.25; P = 0.88); although Hispanic males did have a slightly longer median DTB time compared with whites. During the study, the proportion of patients with DTB times ≤90 minutes increased for all groups, and mortality was similar between groups (white 3.8%, African American 3.0%, Hispanic 4.1%, P = 0.62).ConclusionsIn GWTG-Coronary Artery Disease, small differences in DTB times persist among different races/ethnicities. However, the proportion achieving DTB times ≤90 minutes has increased substantially for all patients over time, and there was no association between race/ethnicity and in-hospital mortality.© 2013 Wiley Periodicals, Inc.

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