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.
From the *Central Baptist Heart and Vascular Institute, Lexington, KY; †Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL; and ‡Department of Emergency Medicine, Rush University Medical Center, Chicago, IL.
Reprints: Gary L. Schaer, MD, Division of Cardiology, Rush University Medical Center, 1653 West Congress Parkway, Suite 1035 Jelke, Chicago, IL 60612. E-mail: Gary_Schaer@rush.edu.