Impact of limited English proficiency on presentation and clinical outcomes of patients undergoing primary percutaneous coronary intervention
Aims: To evaluate the association of limited English proficiency (LEP) with reperfusion times and outcomes in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). Methods and results: This cohort study included 5385 patients who underw...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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OXFORD UNIV PRESS
2020
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| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/1111170 http://hdl.handle.net/20.500.11937/93757 |
| _version_ | 1848765780951302144 |
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| author | Biswas, S. Dinh, D. Lucas, M. Duffy, S.J. Brennan, A. Liew, D. Cox, N. Smith, K. Andrew, E. Nehme, Z. Reid, Christopher Lefkovits, J. Stub, D. |
| author_facet | Biswas, S. Dinh, D. Lucas, M. Duffy, S.J. Brennan, A. Liew, D. Cox, N. Smith, K. Andrew, E. Nehme, Z. Reid, Christopher Lefkovits, J. Stub, D. |
| author_sort | Biswas, S. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Aims: To evaluate the association of limited English proficiency (LEP) with reperfusion times and outcomes in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). Methods and results: This cohort study included 5385 patients who underwent PPCI in 2013-2017 and were prospectively enrolled in the Victorian Cardiac Outcomes Registry. Data linkage to government administrative datasets was performed to identify patients' preferred spoken language, socioeconomic status, and ambulance utilization data. Patients who had a preferred spoken language other than English were defined as having LEP. Of the study cohort, 430 patients (8.0%) had LEP. They had longer mean symptom-to-door time (STDT) [164 (95% confidence interval, CI 149-181) vs. 136 (95% CI 132-140) min, P < 0.001] but similar mean door-to-balloon time [79 (95% CI 72-87) vs. 76 (95% CI 74-78) min, P = 0.41]. They also had higher major adverse cardiovascular and cerebrovascular events (MACCE; 13.5% vs. 9.9%; P = 0.02), severe left ventricular dysfunction (11.0% vs. 8.4%, P = 0.02), and heart failure (HF) hospitalizations within 30 days of PPCI (5.1% vs. 2.0%, P < 0.001). On multivariable analysis, LEP did not independently predict 30-day MACCE [odds ratio (OR) 1.16, 95% CI 0.79-1.69; P = 0.45] but was an independent predictor of both prolonged STDT ≥ 120 min (OR 1.25, 95% CI 1.02-1.52; P = 0.03) and 30-day HF hospitalizations (OR 2.01, 95% CI 1.21-3.36; P = 0.008). Conclusion: Patients with LEP undergoing PPCI present later and are more likely to have HF readmissions within 30 days of percutaneous coronary intervention, but with similar short-term MACCE. More effort to provide education in varied languages on early presentation in STEMI is required. |
| first_indexed | 2025-11-14T11:40:42Z |
| format | Journal Article |
| id | curtin-20.500.11937-93757 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:40:42Z |
| publishDate | 2020 |
| publisher | OXFORD UNIV PRESS |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-937572023-12-21T05:40:56Z Impact of limited English proficiency on presentation and clinical outcomes of patients undergoing primary percutaneous coronary intervention Biswas, S. Dinh, D. Lucas, M. Duffy, S.J. Brennan, A. Liew, D. Cox, N. Smith, K. Andrew, E. Nehme, Z. Reid, Christopher Lefkovits, J. Stub, D. Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology English proficiency Percutaneous coronary intervention Outcomes LENGTH-OF-STAY LANGUAGE PROFICIENCY SEEKING TREATMENT HEART-ATTACK CARE ACCULTURATION HEALTH DELAY INTERPRETERS AWARENESS English proficiency Outcomes Percutaneous coronary intervention Aged Female Follow-Up Studies Hospital Mortality Humans Limited English Proficiency Male Middle Aged Percutaneous Coronary Intervention Prospective Studies Risk Factors ST Elevation Myocardial Infarction Time-to-Treatment Treatment Outcome Victoria Humans Treatment Outcome Hospital Mortality Risk Factors Follow-Up Studies Prospective Studies Aged Middle Aged Victoria Female Male Time-to-Treatment Percutaneous Coronary Intervention ST Elevation Myocardial Infarction Limited English Proficiency Aims: To evaluate the association of limited English proficiency (LEP) with reperfusion times and outcomes in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). Methods and results: This cohort study included 5385 patients who underwent PPCI in 2013-2017 and were prospectively enrolled in the Victorian Cardiac Outcomes Registry. Data linkage to government administrative datasets was performed to identify patients' preferred spoken language, socioeconomic status, and ambulance utilization data. Patients who had a preferred spoken language other than English were defined as having LEP. Of the study cohort, 430 patients (8.0%) had LEP. They had longer mean symptom-to-door time (STDT) [164 (95% confidence interval, CI 149-181) vs. 136 (95% CI 132-140) min, P < 0.001] but similar mean door-to-balloon time [79 (95% CI 72-87) vs. 76 (95% CI 74-78) min, P = 0.41]. They also had higher major adverse cardiovascular and cerebrovascular events (MACCE; 13.5% vs. 9.9%; P = 0.02), severe left ventricular dysfunction (11.0% vs. 8.4%, P = 0.02), and heart failure (HF) hospitalizations within 30 days of PPCI (5.1% vs. 2.0%, P < 0.001). On multivariable analysis, LEP did not independently predict 30-day MACCE [odds ratio (OR) 1.16, 95% CI 0.79-1.69; P = 0.45] but was an independent predictor of both prolonged STDT ≥ 120 min (OR 1.25, 95% CI 1.02-1.52; P = 0.03) and 30-day HF hospitalizations (OR 2.01, 95% CI 1.21-3.36; P = 0.008). Conclusion: Patients with LEP undergoing PPCI present later and are more likely to have HF readmissions within 30 days of percutaneous coronary intervention, but with similar short-term MACCE. More effort to provide education in varied languages on early presentation in STEMI is required. 2020 Journal Article http://hdl.handle.net/20.500.11937/93757 10.1093/ehjqcco/qcz061 English http://purl.org/au-research/grants/nhmrc/1111170 http://purl.org/au-research/grants/nhmrc/1146809 http://purl.org/au-research/grants/nhmrc/11136372 http://purl.org/au-research/grants/nhmrc/11136372 OXFORD UNIV PRESS unknown |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology English proficiency Percutaneous coronary intervention Outcomes LENGTH-OF-STAY LANGUAGE PROFICIENCY SEEKING TREATMENT HEART-ATTACK CARE ACCULTURATION HEALTH DELAY INTERPRETERS AWARENESS English proficiency Outcomes Percutaneous coronary intervention Aged Female Follow-Up Studies Hospital Mortality Humans Limited English Proficiency Male Middle Aged Percutaneous Coronary Intervention Prospective Studies Risk Factors ST Elevation Myocardial Infarction Time-to-Treatment Treatment Outcome Victoria Humans Treatment Outcome Hospital Mortality Risk Factors Follow-Up Studies Prospective Studies Aged Middle Aged Victoria Female Male Time-to-Treatment Percutaneous Coronary Intervention ST Elevation Myocardial Infarction Limited English Proficiency Biswas, S. Dinh, D. Lucas, M. Duffy, S.J. Brennan, A. Liew, D. Cox, N. Smith, K. Andrew, E. Nehme, Z. Reid, Christopher Lefkovits, J. Stub, D. Impact of limited English proficiency on presentation and clinical outcomes of patients undergoing primary percutaneous coronary intervention |
| title | Impact of limited English proficiency on presentation and clinical outcomes of patients undergoing primary percutaneous coronary intervention |
| title_full | Impact of limited English proficiency on presentation and clinical outcomes of patients undergoing primary percutaneous coronary intervention |
| title_fullStr | Impact of limited English proficiency on presentation and clinical outcomes of patients undergoing primary percutaneous coronary intervention |
| title_full_unstemmed | Impact of limited English proficiency on presentation and clinical outcomes of patients undergoing primary percutaneous coronary intervention |
| title_short | Impact of limited English proficiency on presentation and clinical outcomes of patients undergoing primary percutaneous coronary intervention |
| title_sort | impact of limited english proficiency on presentation and clinical outcomes of patients undergoing primary percutaneous coronary intervention |
| topic | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology English proficiency Percutaneous coronary intervention Outcomes LENGTH-OF-STAY LANGUAGE PROFICIENCY SEEKING TREATMENT HEART-ATTACK CARE ACCULTURATION HEALTH DELAY INTERPRETERS AWARENESS English proficiency Outcomes Percutaneous coronary intervention Aged Female Follow-Up Studies Hospital Mortality Humans Limited English Proficiency Male Middle Aged Percutaneous Coronary Intervention Prospective Studies Risk Factors ST Elevation Myocardial Infarction Time-to-Treatment Treatment Outcome Victoria Humans Treatment Outcome Hospital Mortality Risk Factors Follow-Up Studies Prospective Studies Aged Middle Aged Victoria Female Male Time-to-Treatment Percutaneous Coronary Intervention ST Elevation Myocardial Infarction Limited English Proficiency |
| url | http://purl.org/au-research/grants/nhmrc/1111170 http://purl.org/au-research/grants/nhmrc/1111170 http://purl.org/au-research/grants/nhmrc/1111170 http://purl.org/au-research/grants/nhmrc/1111170 http://hdl.handle.net/20.500.11937/93757 |