Academic study details urgent need to address racial disparities in heart attack care

There is an “urgent” need to address racial disparities seen among heart attack patients from different ethnic backgrounds, academics have said.

The remarks follow a new study which found “significant differences” in the care heart attack patients had during the first wave of the coronavirus pandemic.

Researchers found that people from black or Asian heritage and those from ethnic minority backgrounds were more likely to be admitted to hospital than their white peers; less likely to receive evidence-based care; and more likely to die early than before the pandemic.

“Our data suggest that there is an urgent need to address the widening racial disparities in the care of AMI (acute myocardial infarction) patient during the current Covid19 outbreak,” the authors wrote in the journal Heart.

“We found significant differences in the presentation and management of BAME communities compared with the white population, with an associated increased early mortality.”

The new study, led by academics from Keele University, examined data on heart attacks – also known as acute myocardial infarctions (AMI) – during the first wave of the pandemic.

They examined healthcare records from nationwide registries for all patients admitted to hospitals with a heart attack in England between February 1 and May 27 2020 to see if there were any differences in presentation and treatment between white patients and people with other backgrounds.

They also looked at rates from three previous years.

The data from before the pandemic drew on information from 62,578 patients – 90% were from white backgrounds and 10% were deemed to be of “BAME origin”.

But during the first wave of the Covid0-19 pandemic the BAME group rose to 16.7% of heart attack admissions.

This figure also rose during the study period from 16% in February to 18% in May.

The authors also pointed to differences between different groups in the treatments that were received.

The authors said that people with black or Asian heritage as well as those from minority ethnic backgrounds were likely to wait longer for different types of treatment to begin when compared to people from a white background, including reperfusion therapies – a medical treatment to restore blood flow and coronary angiographies – which are used to help diagnose heart conditions or carry out certain procedures.

The finding was true even before the pandemic, but “more pronounced” during the pandemic.

The authors also found higher death rates among people from black or Asian heritage and those from ethnic minority backgrounds during the pandemic compared to previous years.

Patients with these backgrounds were 68% more likely to die in hospital and 81% more likely to die within seven days of discharge compared to before the pandemic.

“BAME patients during Covid-19 were less likely to receive guideline indicated care and had increased mortality compared with pre-Covid-19 era,” the authors wrote.

“Immediate counter-measures are required to increase patient awareness and promote equity in the cardiac care of this underserved population during the ongoing Covid-19 pandemic.”

Commenting on the paper, Dr Sonya Babu-Narayan (pictured), associate medical director at the British Heart Foundation, said: “People whose ethnic background is minority in the UK are experiencing unacceptable inequalities in cardiovascular care and this has been exacerbated by the Covid-19 pandemic.

“Even during a pandemic, it is critical to make sure that everyone gets effective heart attack care.

“It is vital treatment is equally available to all, which will require removing any biases that may be at play and ensuring people know when to come forward and can feel confident doing so.

“If you think you could be having symptoms of a heart attack, it’s important to call 999 immediately – every minute matters and prompt treatment saves lives.

“The NHS has systems in place to safely treat you and emergency care to deliver effective treatment for heart attack has always been available throughout the pandemic.”

Dr Habib Naqvi, director of the NHS Race and Health Observatory, said: “This study exposes yet more disparity concerning the levels of fair access and outcomes to healthcare services for ethnic minority communities.

“This is why the observatory will be exploring and tackling deep-rooted causes of bias in healthcare and its negative impact, which can led to clinicians potentially making the wrong assumptions and subsequently influencing how health services are designed and delivered.”

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