Adverse outcomes in hospitalized patients who develop ST-elevation myocardial infarction.
Crit Pathw Cardiol. 2014 Jun;13(2):62-5
Authors: Richmond T, Holoshitz N, Haryani A, Purim-Shem-Tov Y, Sharma G, Schaer GL
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.
PMID: 24827882 [PubMed - indexed for MEDLINE]