Table 2.
Factors associated with the receipt of selected treatment modalities in patients hospitalized with AMI
| All hospitalized patients |
Patients hospitalized in 2003/2005 |
||||
|---|---|---|---|---|---|
| Characteristicsb | Thrombolytic therapy OR | PCI OR | CABG surgery OR | PCI OR | CABG surgery OR |
| Age (years) | |||||
| 55-64 | 0.89 (0.75,1.05)a | 0.75 (0.64,0.88) | 1.37 (0.99,1.88) | 0.81 (0.57,1.16) | 0.77 (0.35,1.68) |
| 65-74 | 0.69 (0.57,0.83) | 0.72 (0.60,0.85) | 1.45 (1.04,2.01) | 0.72 (0.50,1.04) | 1.85 (0.89,3.85) |
| ≥75 | 0.30 (0.25,0.37) | 0.47 (0.39,0.56) | 0.65 (0.45,0.93) | 0.36 (0.26,0.52) | 0.70 (0.31,1.55) |
| Male sex | 1.03 (0.90,1.17) | 1.09 (0.97,1.23) | 1.38 (1.11,1.71) | 1.48 (1.20,1.81) | 1.14 (0.72,1.79) |
| Body mass index | |||||
| 25-29.9 | 0.89 (0.76,1.03) | 3.94 (3.47,4.48) | 2.05 (1.62,2.59) | 1.84 (1.46,2.33) | 3.20 (1.78,5.75) |
| ≥30 | 0.72 (0.61,0.87) | 4.43 (3.85,5.09) | 2.19 (1.70,2.81) | 1.66 (1.28,2.16) | 2.75 (1.47,5.18) |
| Payment method | |||||
| Private insurance | 0.89 (0.66,1.18) | 1.13 (0.85,1.49) | 0.97 (0.55,1.71) | 1.34 (0.71,2.51) | 1.88 (0.47,7.49) |
| Blue cross | 0.76 (0.59,0.97) | 1.13 (0.89,1.43) | 0.73 (0.44,1.21) | 0.92 (0.56,1.49) | 1.28 (0.39,4.24) |
| Medicaid | 0.69 (0.48,1.01) | 1.18 (0.85,1.63) | 1.08 (0.58,2.02) | 1.02 (0.53,1.98) | 2.59 (0.65,10.27) |
| Medicare | 0.91 (0.73,1.13) | 0.70 (0.57,0.86) | 0.79 (0.54,1.17) | 0.72 (0.46,1.12) | 1.40 (0.46,4.27) |
| HMO | 0.90 (0.73,1.13) | 1.31 (1.09,1.59) | 1.31 (0.91,1.88) | 0.92 (0.60,1.41) | 1.44 (0.49,4.24) |
| Medical history | |||||
| Angina | 0.95 (0.81,1.10) | 1.0 (0.88,1.14) | 2.02 (1.63,2.49) | 1.33 (1.03,1.72) | 0.90 (0.51,1.59) |
| Diabetes | 0.78 (0.68,0.90) | 0.82 (0.72,0.92) | 1.44 (1.17,1.77) | 0.99 (0.79,1.24) | 0.94 (0.59,1.52) |
| Heart failure | 0.33 (0.26,0.43) | 0.70 (0.59,0.83) | 0.43 (0.31,0.59) | 0.64 (0.49,0.83) | 0.34 (0.17,0.66) |
| Stroke | 0.42 (0.31,0.56) | 0.75 (0.61,0.92) | 0.57 (0.39,0.85) | 0.61 (0.44,0.85) | 0.40 (0.16,1.02) |
| Hypertension | 0.89 (0.79,1.00) | 1.28 (1.14,1.44) | 1.31 (1.05,1.63) | 0.88 (0.69,1.12) | 1.43 (0.82,2.49) |
| AMI characteristics | |||||
| Initial | 1.04 (0.90,1.20) | 1.24 (1.10,1.41) | 1.17 (0.94,1.46) | 1.11 (0.89,1.39) | 0.92 (0.57,1.48) |
| Q wave | 3.79 (3.36,4.28) | 1.19 (1.06,1.34) | 0.80 (0.64,0.99) | 2.66 (2.04,3.48) | 0.80 (0.46,1.41) |
| Clinical complications | |||||
| Heart failure | 0.93 (0.81,1.06) | 0.71 (0.63,0.81) | 0.95 (0.76,1.19) | 0.59 (0.46,0.74) | 1.67 (1.02,2.72) |
| Cardiogenic shock | 1.32 (1.05,1.65) | 2.62 (2.15,3.21) | 1.97 (1.43,2.72) | 2.56 (1.61,4.08) | 1.08 (0.45,2.56) |
| Atrial fibrillation | 0.73 (0.61,0.87) | 1.06 (0.91,1.23) | 3.56 (2.86,4.42) | 0.81 (0.63,1.04) | 2.14 (1.33,3.46) |
AMI, acute myocardial infarction; CABG, coronary artery bypass graft surgery; HMO, health maintenance organization; OR, odds ratio; PCI, percutaneous coronary intervention.
a
95% confidence interval.
b
Respective referent categories: age <55, women, body mass index <25, private payment, absence of selected comorbidities, prior myocardial infarction (MI), non-Q wave MI, absence of clinical complications during hospitalization.