Key result
Rural residence links to longer reperfusion and less primary PCI but similar in-hospital mortality.
Why the study?
Whether worse clinical outcomes in rural patients with STEMI are due to clinical characteristics or delays in timely reperfusion with primary PCI or fibrinolysis was unclear.
Does living in a rural versus urban setting affect time-to-reperfusion metrics and in-hospital mortality in patients with STEMI?
Population
70 424 adult patients with STEMI in 686 participating US hospitals
Comparison
Rural vs urban settings
Design
Cross-sectional multicenter study
Authors
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Similar adjusted mortality despite rural STEMI reperfusion gaps; leaves open whether targeted interventions improve equity or outcomes.
Cross-Sectional (n=70,424)
Yes
Does living in a rural versus urban setting affect time-to-reperfusion metrics and in-hospital mortality in patients with STEMI?
Effect estimate: OR 0.97 (95% CI 0.89-1.06)
Despite longer times to reperfusion and lower rates of primary PCI, STEMI patients in rural settings had similar adjusted in-hospital mortality compared to those in urban settings.
Hillerson et al. (2022) conducted a cross-sectional in ST-segment elevation myocardial infarction (STEMI) (n=70,424). Rural setting vs. Urban setting was evaluated on In-hospital mortality (OR 0.97, 95% CI 0.89-1.06). Rural residence was associated with longer reperfusion times and less primary PCI than urban residence, but adjusted in-hospital mortality did not significantly differ (OR 0.97; 95% CI 0.89-1.06).
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