Rashmee U Shah1, Timothy D Henry2, Stephanie Rutten-Ramos, Ross F Garberich3, Mourad Tighiouart4, C Noel Bairey Merz5. 1. University of Utah School of Medicine, Salt Lake City, Utah. Electronic address: Rashmee.Shah@utah.edu. 2. Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California; Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, Minnesota. 3. Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, Minnesota. 4. Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California. 5. Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California; Barbra Streisand Women's Heart Center, Cedars-Sinai Medical Center, Los Angeles, California.
Abstract
OBJECTIVES: The aim of this study was to quantify changes in percutaneous coronary intervention (PCI) and mortality rates for ST-segment elevation myocardial infarction (STEMI), and the proportion of hospitals providing STEMI-related PCI in the United States. BACKGROUND: Health care systems have recently emphasized rapid access to PCI for STEMI, but the effects of these efforts in a broad population are unknown. METHODS: We used the Nationwide Inpatient Sample, a discharge database representative of all short-term, nonfederal hospitals in the United States. STEMI discharges were included based on primary discharge diagnosis. We calculated the adjusted odds ratio (OR) of PCI and in-hospital death over time and the changing proportion of hospitals providing STEMI-related PCI. RESULTS: From 2003 to 2011, STEMI accounted for 380,254 hospital discharges. The rate of PCI increased from 53.6% to 80.0% with an adjusted OR of 4.16 (95% confidence interval [CI]: 3.71 to 4.66) in 2011 compared with 2003. The proportion of hospitals providing STEMI-related PCI increased from 25.1% in 2003 to 33.7% in 2011. In-hospital death rates ranged from 7.2% to 9.5%, with the lowest rate in 2009. The OR of death decreased from 2003 to 2011 (adjusted OR: 0.79 in 2011 compared with 2003; 95% CI: 0.74 to 0.84). After accounting for PCI, the OR of in-hospital death did not change between 2003 and 2011 (adjusted OR: 1.01 in 2011 compared with 2003; 95% CI: 0.95 to 1.07). CONCLUSIONS: PCI rates and hospitals providing STEMI-related PCI increased from 2003 to 2011, whereas in-hospital death rates decreased. PCI was an important mediator of decreasing mortality in this nationally representative sample.
OBJECTIVES: The aim of this study was to quantify changes in percutaneous coronary intervention (PCI) and mortality rates for ST-segment elevation myocardial infarction (STEMI), and the proportion of hospitals providing STEMI-related PCI in the United States. BACKGROUND: Health care systems have recently emphasized rapid access to PCI for STEMI, but the effects of these efforts in a broad population are unknown. METHODS: We used the Nationwide Inpatient Sample, a discharge database representative of all short-term, nonfederal hospitals in the United States. STEMI discharges were included based on primary discharge diagnosis. We calculated the adjusted odds ratio (OR) of PCI and in-hospital death over time and the changing proportion of hospitals providing STEMI-related PCI. RESULTS: From 2003 to 2011, STEMI accounted for 380,254 hospital discharges. The rate of PCI increased from 53.6% to 80.0% with an adjusted OR of 4.16 (95% confidence interval [CI]: 3.71 to 4.66) in 2011 compared with 2003. The proportion of hospitals providing STEMI-related PCI increased from 25.1% in 2003 to 33.7% in 2011. In-hospital death rates ranged from 7.2% to 9.5%, with the lowest rate in 2009. The OR of death decreased from 2003 to 2011 (adjusted OR: 0.79 in 2011 compared with 2003; 95% CI: 0.74 to 0.84). After accounting for PCI, the OR of in-hospital death did not change between 2003 and 2011 (adjusted OR: 1.01 in 2011 compared with 2003; 95% CI: 0.95 to 1.07). CONCLUSIONS: PCI rates and hospitals providing STEMI-related PCI increased from 2003 to 2011, whereas in-hospital death rates decreased. PCI was an important mediator of decreasing mortality in this nationally representative sample.
Authors: Mervyn Singer; Clifford S Deutschman; Christopher Warren Seymour; Manu Shankar-Hari; Djillali Annane; Michael Bauer; Rinaldo Bellomo; Gordon R Bernard; Jean-Daniel Chiche; Craig M Coopersmith; Richard S Hotchkiss; Mitchell M Levy; John C Marshall; Greg S Martin; Steven M Opal; Gordon D Rubenfeld; Tom van der Poll; Jean-Louis Vincent; Derek C Angus Journal: JAMA Date: 2016-02-23 Impact factor: 56.272
Authors: James G Jollis; Hussein R Al-Khalidi; Mayme L Roettig; Peter B Berger; Claire C Corbett; Harold L Dauerman; Christopher B Fordyce; Kathleen Fox; J Lee Garvey; Tammy Gregory; Timothy D Henry; Ivan C Rokos; Matthew W Sherwood; Robert E Suter; B Hadley Wilson; Christopher B Granger Journal: Circulation Date: 2016-08-02 Impact factor: 29.690
Authors: Héctor E Flores-Salinas; Fidel Casillas-Muñoz; Yeminia Valle; Cesar M Guzmán-Sánchez; Jorge Ramon Padilla-Gutiérrez Journal: Cardiol Res Pract Date: 2020-07-06 Impact factor: 1.866
Authors: Kristian Kragholm; Di Lu; Karen Chiswell; Hussein R Al-Khalidi; Mayme L Roettig; Matthew Roe; James Jollis; Christopher B Granger Journal: J Am Heart Assoc Date: 2017-10-11 Impact factor: 5.501
Authors: Ahmed AlBadri; Derek Leong; C Noel Bairey Merz; Janet Wei; Eileen M Handberg; Chrisandra L Shufelt; Puja K Mehta; Michael D Nelson; Louise E Thomson; Daniel S Berman; Leslee J Shaw; Galen Cook-Wiens; Carl J Pepine Journal: Clin Cardiol Date: 2017-06-12 Impact factor: 3.287