Table 2:
Characteristics of patient with ST segment elevation myocardial infarction.
| 2001 | 2006 | 2011 | p for interaction | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Urban * | Rural * | OR (95% CI)# | Urban * | Rural * | OR (95% CI)# | Urban * | Rural * | OR (95% CI) # | ||
| n=1341 | n=786 | n=2388 | n=1604 | n=4601 | n=3095 | |||||
| Demographics | ||||||||||
| Age, yr | ||||||||||
| <60 | 428 (32%) | 267 (34%) | 0·89 (0·73, 1·10) | 810 (34%) | 514 (32%) | 1·10 (0·96, 1·25) | 1769 (39%) | 927 (29%) | 1·58 (1·43, 1·74) | <0·001 |
| 60–69 | 465 (35%) | 246 (31%) | 1·19 (0·97, 1·46) | 622 (26%) | 416 (26%) | 0·95 (0·83, 1·10) | 1124 (25%) | 811 (27%) | 0·93 (0·83, 1·03) | 0·05 |
| 70–79 | 354 (26%) | 216 (28%) | 0·94 (0·76, 1·17) | 752 (32%) | 522 (32%) | 0·98 (0·85, 1·12) | 1238 (26%) | 915 (30%) | 0·82 (0·74, 0·90) | 0·07 |
| ≥80 | 94 (7%) | 57 (7%) | 0·99 (0·68, 1·44) | 204 (9%) | 152 (9%) | 0·92 (0·74, 1·15) | 470 (10%) | 442 (14%) | 0·64 (0·56, 0·73) | 0·003 |
| Female sex | 392 (29%) | 222 (29%) | 1·02 (0·82, 1·26) | 679 (28%) | 458 (29%) | 0·96 (0·84, 1·11) | 1263 (28%) | 984 (33%) | 0·80 (0·72, 0·88) | 0·01 |
| Cardiovascular risk factors | ||||||||||
| Hypertension | 590 (45%) | 276 (36%) | 1·45 (1·19, 1·77) | 1232 (54%) | 662 (43%) | 1·56 (1·37, 1·77) | 2451 (54%) | 1439 (48%) | 1·25 (1·14, 1·37) | 0·3 |
| Diabetes | 230 (17%) | 66 (8%) | 2·27 (1·66, 3·10) | 555 (25%) | 192 (12%) | 2·50 (2·09, 2·99) | 1078 (24%) | 480 (16%) | 1·60 (1·42, 1·80) | <0·001 |
| Dyslipidaemia | 664 (52%) | 244 (31%) | 2·32 (1·89, 2·84) | 1329 (57%) | 772 (49%) | 1·35 (1·19, 1·54) | 3004 (68%) | 1839 (59%) | 1·43 (1·30, 1·58) | 0·004 |
| Current smoker | 408 (32%) | 221 (28%) | 1·16 (0·94, 1·44) | 807 (36%) | 499 (34%) | 1·08 (0·94, 1·23) | 1889 (43%) | 965 (33%) | 1·54 (1·40, 1·70) | <0·001 |
| Number of risk factors | ||||||||||
| ≥3 risk factors | 169 (13%) | 45 (6%) | 2·46 (1·71, 3·55) | 468 (22%) | 190 (13%) | 1·81 (1·52, 2·16) | 1126 (26%) | 486 (17%) | 1·76 (1·57, 1·97) | 0·2 |
| 2 risk factors | 438 (34%) | 171 (22%) | 1·83 (1·47, 2·29) | 849 (36%) | 459 (29%) | 1·38 (1·20, 1·58) | 1807 (40%) | 1071 (35%) | 1·27 (1·15, 1·39) | 0·006 |
| 1 risk factors | 496 (36%) | 326 (42%) | 0·79 (0·65, 0·96) | 767 (30%) | 623 (38%) | 0·72 (0·63, 0·82) | 1289 (26%) | 1068 (35%) | 0·66 (0·60, 0·73) | 0·09 |
| None | 238 (17%) | 244 (31%) | 0·46 (0·36, 0·58) | 304 (11%) | 332 (19%) | 0·53 (0·44, 0·63) | 379 (7%) | 470 (14%) | 0·50 (0·43, 0·59) | 0·7 |
| Medical history | ||||||||||
| Myocardial infarction | 154 (11%) | 64 (9%) | 1·37 (0·99, 1·90) | 226 (10%) | 148 (10%) | 1·06 (0·86, 1·31) | 539 (12%) | 275 (9%) | 1·37 (1·18, 1·59) | 0·4 |
| Coronary heart disease | 357 (27%) | 146 (19%) | 1·52 (1·21, 1·93) | 486 (21%) | 304 (19%) | 1·11 (0·95, 1·30) | 977 (22%) | 591 (19%) | 1·17 (1·04, 1·31) | 0·1 |
| PCI | 8 (1%) | 6 (1%) | 0·77 (0·27, 2·24) | 28 (1%) | 12 (1%) | 1·25 (0·68, 2·31) | 134 (3%) | 46 (2%) | 1·91 (1·39, 2·63) | 0·06 |
| CABG | 3 (0%) | 7 (1%) | 0·29 (0·08, 1·05) | 6 (0%) | 3 (0%) | 1·23 (0·40, 3·74) | 14 (0%) | 7 (0%) | 0·93 (0·37, 2·34) | 0·2 |
| Stroke | 126 (9%) | 72 (10%) | 0·97 (0·70, 1·34) | 276 (12%) | 145 (9%) | 1·35 (1·10, 1·67) | 562 (12%) | 335 (12%) | 1·06 (0·92, 1·22) | 0·6 |
| Clinical characteristics | ||||||||||
| Symptom onset to admission, hr ‡ | ||||||||||
| <3 | 253 (19%) | 152 (20%) | 0·94 (0·75, 1·17) | 436 (17%) | 348 (23%) | 0·70 (0·60, 0·83) | 767 (16%) | 712 (23%) | 0·63 (0·56, 0·71) | 0·003 |
| 3 to <6 | 232 (18%) | 115 (14%) | 1·29 (1·01, 1·65) | 342 (15%) | 276 (17%) | 0·83 (0·69, 0·99) | 691 (16%) | 560 (19%) | 0·82 (0·72, 0·93) | 0·006 |
| 6 to <12 | 130 (10%) | 88 (11%) | 0·89 (0·66, 1·19) | 281 (13%) | 185 (12%) | 1·03 (0·84, 1·26) | 517 (12%) | 377 (12%) | 1·00 (0·86, 1·16) | 0·6 |
| 12 to <24 | 100 (8%) | 73 (9%) | 0·85 (0·62, 1·17) | 145 (6%) | 131 (8%) | 0·75 (0·58, 0·97) | 341 (8%) | 220 (7%) | 1·05 (0·87, 1·27) | 0·1 |
| ≥24 | 599 (45%) | 348 (45%) | 1·00 (0·83, 1·19) | 1093 (49%) | 652 (40%) | 1·48 (1·29, 1·69) | 1932 (48%) | 1160 (38%) | 1·49 (1·35, 1·65) | 0·001 |
| Chest discomfort | 1244 (93%) | 726 (93%) | 1·09 (0·75, 1·58) | 2216 (93%) | 1464 (92%) | 1·28 (1·01, 1·63) | 4275 (93%) | 2843 (92%) | 1·23 (1·04, 1·47) | 0·7 |
| Cardiac arrest | 17 (1%) | 4 (0%) | 2·71 (0·77, 9·57) | 39 (2%) | 10 (1%) | 2·88 (1·48, 5·59) | 88 (2%) | 37 (1%) | 1·26 (0·88, 1·81) | 0·04 |
| Cardiogenic shock | 53 (4%) | 41 (5%) | 0·74 (0·47, 1·16) | 136 (5%) | 109 (7%) | 0·74 (0·57, 0·96) | 293 (6%) | 215 (7%) | 0·91 (0·75, 1·09) | 0·2 |
| Acute stroke | 13 (1%) | 5 (1%) | 1·43 (0·46, 4·43) | 39 (2%) | 30 (2%) | 0·98 (0·60, 1·59) | 49 (1%) | 34 (1%) | 0·78 (0·49, 1·24) | 0·3 |
| Heart rate, beat/min | ||||||||||
| <50 | 73 (5%) | 36 (5%) | 1·17 (0·75, 1·81) | 131 (5%) | 90 (5%) | 0·92 (0·69, 1·22) | 201 (4%) | 183 (7%) | 0·58 (0·47, 0·71) | 0·001 |
| 50–110 | 1190 (89%) | 698 (89%) | 0·97 (0·71, 1·31) | 2099 (89%) | 1395 (87%) | 1·15 (0·95, 1·40) | 4188 (92%) | 2729 (88%) | 1·57 (1·35, 1·82) | 0·001 |
| >110 | 78 (6%) | 52 (6%) | 0·93 (0·63, 1·39) | 158 (6%) | 119 (8%) | 0·85 (0·66, 1·08) | 212 (4%) | 183 (6%) | 0·74 (0·60, 0·91) | 0·2 |
| Systolic blood pressure, mm Hg | ||||||||||
| <90 | 87 (6%) | 67 (8%) | 0·73 (0·50, 1·05) | 132 (5%) | 132 (8%) | 0·58 (0·45, 0·75) | 216 (4%) | 192 (5%) | 0·81 (0·65, 1·00) | 0·3 |
| 90–139 | 836 (63%) | 445 (56%) | 1·31 (1·08, 1·59) | 1473 (63%) | 926 (57%) | 1·25 (1·10, 1·42) | 2855 (63%) | 1803 (57%) | 1·26 (1·15, 1·39) | 0·8 |
| ≥140 | 418 (31%) | 274 (36%) | 0·82 (0·67, 1·01) | 783 (33%) | 546 (35%) | 0·91 (0·80, 1·04) | 1530 (33%) | 1100 (37%) | 0·82 (0·74, 0·90) | 0·6 |
| eGFR† | ||||||||||
| Unmeasured | 401 (27) | 432 (54) | 0·32 (0·26, 0·39) | 344 (12%) | 452 (25%) | 0·41 (0·35, 0·48) | 275 (5%) | 343 (10%) | 0·49 (0·41, 0·58) | 0·01 |
| < 30 | 41 (3%) | 26 (3%) | 0·97 (0·56, 1·65) | 98 (4%) | 42 (3%) | 1·55 (1·08, 2·25) | 139 (3%) | 93 (3%) | 1·11 (0·85, 1·46) | 0·8 |
| 30–59 | 223 (17%) | 94 (12%) | 1·49 (1·13, 1·96) | 452 (18%) | 304 (18%) | 1·01 (0·86, 1·19) | 733 (15%) | 530 (16%) | 0·93 (0·82, 1·05) | 0·007 |
| ≥ 60 | 676 (52%) | 234 (30%) | 2·50 (2·04, 3·07) | 1494 (65%) | 806 (54%) | 1·62 (1·43, 1·85) | 3454 (76%) | 2129 (71%) | 1·33 (1·20, 1·48) | <0·001 |
| Ejection fraction † | ||||||||||
| Unmeasured | 1021 (74) | 680 (86) | 0·45 (0·35, 0·58) | 1085 (50) | 1212 (72) | 0·38 (0·33, 0·44) | 1562 (30) | 1813 (55) | 0·35 (0·32, 0·38) | 0·03 |
| <40% | 38 (3%) | 20 (3%) | 1·25 (0·70, 2·23) | 176 (8%) | 69 (4%) | 1·86 (1·39, 2·48) | 295 (7%) | 146 (5%) | 1·46 (1·19, 1·80) | 0·7 |
| ≥40% | 282 (23%) | 86 (11%) | 2·37 (1·79, 3·14) | 927 (43%) | 323 (24%) | 2·42 (2·10, 2·79) | 2744 (64%) | 1136 (41%) | 2·58 (2·35, 2·83) | 0·3 |
| Transfer | ||||||||||
| Transfer in | 27 (2%) | 10 (1%) | 1·76 (0·77, 3·99) | 91 (4%) | 12 (1%) | 4·64 (2·71, 7·95) | 353 (9%) | 66 (4%) | 2·74 (2·20, 3·41) | 0·7 |
| Transfer out | 74 (5%) | 70 (9%) | 0·58 (0·40, 0·85) | 111 (5%) | 164 (11%) | 0·39 (0·31, 0·51) | 232 (4%) | 520 (16%) | 0·21 (0·17, 0·25) | <0·001 |
OR indicates odds ratio; CI, confidence interval; PCI, percutaneous coronary intervention; CABG, coronary artery bypass grafting; eGFR, estimated glomerular filtration rate.
*
Category variables displayed as number (weighed percentage).
‡
Excluding patients who were transferred in.
†
Among patients with the measurement.
#
With patients in rural hospital as the reference group