Socioeconomic status influences delays in the management of acute ST-elevation myocardial infarction

Abstract Background A prompt diagnosis to initiate the appropriate reperfusion therapy is crucial to improve clinical outcomes in acute ST-elevation myocardial infarction (STEMI) patients. Socio-economic status (SES) refers to parameters like income, educational status and occupation. A low SES negatively interferes with the prognosis of STEMI patients. However, the impact of SES on delay time in acute STEMI remains matter of debate. Methods We used databases from two French multicentric and prospective registries: ACIRA (patients undergoing coronary angiography in any catheterization laboratories of Aquitaine) and REANIM (acute STEMI patients supported by emergency medical system (EMS) in Aquitaine). An ecological indicator of social deprivation Fdep09 was calculated to describe geographical inequalities in health based on municipality of residence. The higher the value, the more disadvantaged the population. Low SES was defined as Fdep09 > median value. Results Two-thousand-eight-hundred-and-forty consecutive patients with acute STEMI undergoing coronary angiography from January 2017 to December 2018 in Aquitaine were included. Patients with lower SES were more often initially referred to emergency departments of non-percutaneous coronary intervention capable centers whereas patients with higher SES were more often directly transferred to PCI centers by the mobile emergency care units as recommended by the most recent European guidelines (p