STEMI patients from rural settings have worse clinical outcomes than urban population

USA: According to a recent study published in JAMA Cardiology, rural ST-segment elevation myocardial infarction (STEMI) patients experienced longer delays to reperfusion. Also, they were less likely to have primary percutaneous coronary intervention (PPCI) or meet guideline-recommended timings to reperfusion and were more inclined to receive fibrinolytic compared to urban STEMI patients.

Although acute ST-segment elevation myocardial infarction (STEMI) mortality has decreased recently and coronary therapy has improved, STEMI is still one of the deadliest diseases. When compared to their urban counterparts, patients with ST-segment elevation myocardial infarction who live in rural areas frequently experience inferior clinical results. Uncertainty exists on the cause of this disparity, which may be brought on by clinical traits or delays in prompt reperfusion following primary percutaneous coronary intervention (PPCI) or fibrinolysis.

The authors aimed to evaluate process parameters and results for STEMI patients in both urban and rural locations across the US.

For this purpose, a cross-sectional multicenter analysis examined information for 70,424 adult STEMI patients from 686 enrolling US hospitals that participated in the National Cardiovascular Data Registry Chest Pain-MI Registry between January 1, 2019, and June 30, 2020. Patients without a verified zip code were eliminated, and outcome analysis did not include patients who were transferred to another hospital throughout the course of the trial. The primary outcomes were in-hospital mortality and time-to-reperfusion measures.