{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:57:07Z","timestamp":1793087827891,"version":"4.5.0"},"reference-count":21,"publisher":"American Medical Association (AMA)","issue":"20","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2022,11,22]]},"abstract":"\n Importance<\/jats:title>\n Recognizing the association between timely treatment and less myocardial injury for patients with ST-segment elevation myocardial infarction (STEMI), US national guidelines recommend specific treatment-time goals.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To describe these process measures and outcomes for a recent cohort of patients.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n Cross-sectional study of a diagnosis-based registry between the second quarter of 2018 and the third quarter of 2021 for 114\u202f871 patients with STEMI treated at 648 hospitals in the Get With The Guidelines\u2013Coronary Artery Disease registry.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n STEMI or STEMI equivalent.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Treatment times, in-hospital mortality, and adherence to system goals (75% treated \u226490 minutes of first medical contact if the first hospital is percutaneous coronary intervention [PCI]-capable and \u2264120 minutes if patients require transfer to a PCI-capable hospital).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In the study population, median age was 63 (IQR, 54-72) years, 71% were men, and 29% were women. Median time from symptom onset to PCI was 148 minutes (IQR, 111-226) for patients presenting to PCI-capable hospitals by emergency medical service, 195 minutes (IQR, 127-349) for patients walking in, and 240 minutes (IQR, 166-402) for patients transferred from another hospital. Adjusted in-hospital mortality was lower for those treated within target times vs beyond time goals for patients transported via emergency medical services (first medical contact to laboratory activation \u226420 minutes [in-hospital mortality, 3.6 vs 9.2] adjusted OR, 0.54 [95% CI, 0.48-0.60], and first medical contact to device \u226490 minutes [in-hospital mortality, 3.3 vs 12.1] adjusted OR, 0.40 [95% CI, 0.36-0.44]), walk-in patients (hospital arrival to device \u226490 minutes [in-hospital mortality, 1.8 vs 4.7] adjusted OR, 0.47 [95% CI, 0.40-0.55]), and transferred patients (door-in to door-out time &amp;lt;30 minutes [in-hospital mortality, 2.9 vs 6.4] adjusted OR, 0.51 [95% CI, 0.32-0.78], and first hospital arrival to device \u2264120 minutes [in-hospital mortality, 4.3 vs 14.2] adjusted OR, 0.44 [95% CI, 0.26-0.71]). Regardless of mode of presentation, system goals were not met in most quarters, with the most delayed system performance among patients requiring interhospital transfer (17% treated \u2264120 minutes).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This study of patients with STEMI included in a US national registry provides information on changes in process and outcomes between 2018 and 2021.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2022.20149","type":"journal-article","created":{"date-parts":[[2022,11,6]],"date-time":"2022-11-06T11:30:30Z","timestamp":1667734230000},"page":"2033","source":"Crossref","is-referenced-by-count":111,"title":["Treatment Time and In-Hospital Mortality Among Patients With ST-Segment Elevation Myocardial Infarction, 2018-2021"],"prefix":"10.1001","volume":"328","author":[{"given":"James G.","family":"Jollis","sequence":"first","affiliation":[{"name":"Lindner Center for Research and Education, Cincinnati, Ohio"},{"name":"Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher B.","family":"Granger","sequence":"additional","affiliation":[{"name":"Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica K.","family":"Z\u00e8gre-Hemsey","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy D.","family":"Henry","sequence":"additional","affiliation":[{"name":"Lindner Center for Research and Education, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhinav","family":"Goyal","sequence":"additional","affiliation":[{"name":"Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline E.","family":"Tamis-Holland","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayme Lou","family":"Roettig","sequence":"additional","affiliation":[{"name":"Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murtuza J.","family":"Ali","sequence":"additional","affiliation":[{"name":"Louisiana State University Health Sciences Center, New Orleans"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"French","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram","family":"Poudel","sequence":"additional","affiliation":[{"name":"American Heart Association, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Zhao","sequence":"additional","affiliation":[{"name":"American Heart Association, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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