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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Are district general hospital patients with unstable angina at a disadvantage?

C Miller1, K Lipscomb, N Curzen

  • 1University of Manchester Medical School, UK.

Postgraduate Medical Journal
|March 4, 2003
PubMed

Insights

Patients with non-ST elevation acute coronary syndromes admitted to district general hospitals face longer waits for angiography and revascularisation compared to those admitted to a tertiary cardiac centre, indicating postcode-based inequity.

Area of Science:

  • Cardiology
  • Health Services Research

Background:

  • Access to timely cardiac procedures is crucial for patients with acute coronary syndromes.
  • District general hospitals (DGHs) may have varying access levels to tertiary cardiac services compared to base hospitals.

Purpose of the Study:

  • To compare access to coronary angiography and revascularisation for patients with non-ST elevation acute coronary syndromes admitted to DGHs versus a tertiary cardiac centre.
  • To identify potential disparities in care based on hospital admission location.

Main Methods:

  • Prospective monitoring of 184 patients with non-ST elevation acute coronary syndromes undergoing angiography and revascularisation over three months.
  • Comparison of waiting times from admission to procedures between patients admitted to a DGH and those admitted directly to the Manchester Heart Centre (MRI).

Main Results:

  • Patients admitted to DGHs waited significantly longer for angiography (median 13 days) and revascularisation (median 15 days) compared to MRI patients (5 and 6 days, respectively).
  • Once transferred to the tertiary centre, DGH patients received angiography rapidly (median 1 day).
  • A higher proportion of DGH patients underwent coronary artery bypass grafting (22%) and percutaneous coronary intervention (46%) compared to MRI patients (9% and 36%).

Conclusions:

  • Significant delays in accessing invasive cardiac procedures exist for patients with non-ST elevation acute coronary syndromes admitted to DGHs.
  • This inequity in access appears to be determined by geographical location (postcode) rather than clinical urgency.
Abstract

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