Improving Care of STEMI in the United States 2008 to 2012
Key result
Over 5 years of the Mission: Lifeline program, adjusted in-hospital mortality for STEMI patients without cardiac arrest decreased by 25% (P<0.001), despite an increase in overall mortality.
Why the study?
To determine changes in treatment strategies and times to treatment over the first 5 years of the Mission: Lifeline program.
Did the implementation of the Mission: Lifeline program improve reperfusion times and in-hospital mortality for patients with STEMI?
Population
147 466 STEMI patients from 485 US hospitals
Comparison
Temporal changes in care from 2008 to 2012
Design
Registry-based observational study
Follow-up
In-hospital
Authors
Discussion
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Member takes
Implication
Associated mortality reductions support regional STEMI systems; leaves open direct causality in this observational cohort.
Study Design
Type
Observational (n=147,466)
Multicenter
Yes
Structured PICO
Did the implementation of the Mission: Lifeline program improve reperfusion times and in-hospital mortality for patients with STEMI?
P
Population
147,466 patients with ST-segment-elevation myocardial infarction (STEMI) treated at 485 US hospitals between 2008 and 2012
I
Intervention
Treatment during the first 5 years of the Mission: Lifeline program (2008 to 2012)
C
Comparator
Temporal comparison across the 5-year period (e.g., 2008 vs 2012)
O
Outcome
Change in treatment strategies, times to treatment (including first medical contact-to-device, door-to-device, and door-in-door-out), and in-hospital mortalityhard clinical
Main Result
Absolute Event Rate: 6.3% vs 5.7%
The Mission: Lifeline program was associated with significant improvements in reperfusion times and a reduction in adjusted in-hospital mortality for STEMI patients without cardiac arrest over a 5-year period.
Cite This Study
Granger et al. (2018) conducted an observational in ST-segment-elevation myocardial infarction (n=147,466). Mission: Lifeline program vs. Temporal trends (2008 vs 2012) was evaluated on Overall in-hospital mortality. Over 5 years of the Mission: Lifeline program, adjusted in-hospital mortality for STEMI patients without cardiac arrest decreased by 25% (P<0.001), despite an increase in overall mortality.