title: Symptom-to-door times in patients presenting with ST elevation myocardial infarction--do ethnic or gender differences exist?
abstract: BACKGROUND
  Studies have shown higher in-hospital mortality for female patients and ethnic minorities admitted to hospital with acute ST elevation myocardial infarction (STEMI). Pre-hospital delay is thought to be associated with increased in-hospital mortality.
  
  
  OBJECTIVE
  To assess the impact of gender and ethnicity on symptom-to-door time (STDT) in patients presenting with STEMI.
  
  
  METHODS
  Retrospective survey of consecutive patients receiving primary percutaneous coronary intervention between January 2008 and January 2013. A multivariate model was used to adjust for confounders.
  
  
  METHODS
  Influence of gender and ethnicity on STDT.
  
  
  RESULTS
  We analysed 1020 patients (75% male, 263 South Asians, 38 Afro Caribbeans and 719 White Europeans.) There was a trend towards longer unadjusted median STDT in women compared with men (132 min vs. 113 min P = 0.07) which disappeared after correction for age and ethnicity (P = 0.15). There was no gender difference in hospital mortality after correction for age (odds ratio 0.69, 95% confidence interval 0.40-1.18, P = 0.17). On linear regression analysis South Asians showed a trend towards longer STDT than other ethnic groups (P = 0.08) however after adjustment for diabetes there was no association between South Asian ethnicity and hospital mortality.
  
  
  CONCLUSIONS
  Neither female gender nor ethnicity were shown to be associated with significant pre-hospital delay.
authors.affiliation: From the University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK and.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Brown
authors.affiliation: From the University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK and Cardiology Department at Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham and Sandwell Hospital, West Bromwich, UK.
authors.forename: Eduard
authors.initials: E
authors.lastname: Shantsila
authors.affiliation: Cardiology Department at Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham and Sandwell Hospital, West Bromwich, UK.
authors.forename: Chetan
authors.initials: C
authors.lastname: Varma
authors.affiliation: From the University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK and Cardiology Department at Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham and Sandwell Hospital, West Bromwich, UK richardbrown4@nhs.net.
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000208:ethnology* / Q000628:therapy*; D012737:Sex Factors; D013997:Time Factors; D061665:Time-to-Treatment / Q000706:statistics & numerical data; D016896:Treatment Outcome; D044465:White People / Q000706:statistics & numerical data