Key result
Developing STEMI while hospitalized was associated with delayed reperfusion, longer hospitalization, more stent thrombosis, and higher 30-day and 1-year mortality compared to ED presentation.
Why the study?
Do patients who develop STEMI while hospitalized have worse outcomes compared to those presenting to the ED with STEMI?
Cohort (n=172)
No
Do patients who develop STEMI while hospitalized have worse outcomes compared to those presenting to the ED with STEMI?
Patients who develop STEMI while already hospitalized for other conditions face significantly worse clinical outcomes, including higher mortality and stent thrombosis, highlighting the need for dedicated inpatient STEMI protocols.
BACKGROUND: There has been considerable emphasis on the care of patients with ST-elevation myocardial infarction (STEMI) with the wide implementation of protocols to quickly identify and triage them from the emergency department (ED) to a cardiac catheterization laboratory for percutaneous coronary intervention. However, a small but important number of patients with STEMI develop ST-elevation while hospitalized for another medical problem. METHODS: A single-center, retrospective chart review was performed on 172 consecutive patients with STEMI who underwent emergency percutaneous coronary intervention. One hundred thirty-seven patients presenting to the ED with STEMI and 35 patients who developed STEMI while hospitalized were compared. RESULTS: Hospitalized patients with STEMI had delayed reperfusion, longer hospitalization, greater rates of stent thrombosis, and greater 30-day and 1-year mortality compared with these in patients presenting with STEMI to the ED. CONCLUSIONS: Optimized clinical pathways for prevention, early diagnosis, and expedited reperfusion of inpatients with STEMI are urgently needed.
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Richmond et al. (2014) conducted a cohort in ST-elevation myocardial infarction (n=172). Inpatient STEMI development vs. ED presentation with STEMI was evaluated on Reperfusion time, hospitalization length, stent thrombosis, and 30-day and 1-year mortality. Developing STEMI while hospitalized was associated with delayed reperfusion, longer hospitalization, more stent thrombosis, and higher 30-day and 1-year mortality compared to ED presentation.
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