Graduation Year

2010

Document Type

Thesis

Degree

M.S.P.H.

Degree Granting Department

Epidemiology and Biostatistics

Major Professor

Elizabeth Pathak, Ph.D.

Co-Major Professor

James A. Mortimer, Ph.D.

Committee Member

Wei Wang, Ph.D.

Keywords

Alzheimer‟s, STEMI, Elderly, Cardiovascular, Disparity

Abstract

Regardless of age or mental capacity, percutaneous coronary intervention (PCI) is the first line of treatment for ST-elevated myocardial infarction (STEMI). This study evaluates the disparities in the use of diagnostic cardiac catheterization and PCI in STEMI patients with dementia. A retrospective analysis was performed of Florida‟s comprehensive inpatient surveillance system for the years 2006-2007 with admission diagnosis of STEMI. Logistic regression analysis was used to identify disparities in the use of intervention among all STEMI patients. A total of 8,331 STEMI patients met the inclusion criteria. Of these, 77% were catheterized and of these 67% received PCI. A total of 605 (7.3%) were demented. Patients with dementia were less likely to be catheterized (RR 0.4, 95% CI 0.3-0.5) and less likely to receive PCI within 24 hours (RR 0.5, 95% CI 0.4-0.6). This study concludes that STEMI patients with dementia were much less likely to receive cardiovascular interventions.

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