Treatment Time and In-Hospital Mortality Among Patients With ST-Segment Elevation Myocardial Infarction, 2018-2021
Key result
PCI within 90 minutes for EMS-transported STEMI is linked to ~60% lower in-hospital mortality.
- 3.3% vs 12.1%
Why the study?
US national guidelines recommend specific treatment-time goals for STEMI, but contemporary descriptions of these process measures and outcomes were needed.
Does treatment within guideline-directed time goals reduce in-hospital mortality in patients with STEMI?
Population
114 871 patients with STEMI at 648 hospitals
Comparison
Treatment within target times vs beyond time goals
Design
Cross-sectional registry study
Follow-up
In-hospital
Authors
Discussion
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Member takes
Implication
Meeting time goals was associated with lower STEMI mortality; extends observational support but leaves open causal effects on outcomes.
Structured PICO
Does treatment within guideline-directed time goals reduce in-hospital mortality in patients with STEMI?
P
Population
114,871 patients with STEMI or STEMI equivalent treated at 648 hospitals in the US Get With The Guidelines–Coronary Artery Disease registry between 2018 and 2021. Median age 63, 71% men.
I
Intervention
Treatment within target times (e.g., first medical contact to device ≤90 minutes for EMS, hospital arrival to device ≤90 minutes for walk-in, first hospital arrival to device ≤120 minutes for transferred patients)
C
Comparator
Treatment beyond target time goals
O
Outcome
Treatment times, in-hospital mortality, and adherence to system goalshard clinical
Timely treatment of STEMI within guideline-recommended goals is associated with significantly lower in-hospital mortality, though adherence to these goals remains suboptimal, particularly for transferred patients.
Cite This Study
Jollis et al. (2022) studied this question. In-hospital mortality for STEMI was reduced by 60% when PCI was performed within 90 minutes versus beyond this time goal for patients transported by emergency services (3.3% vs 12.1%).