{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T16:39:13Z","timestamp":1764002353284,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T00:00:00Z","timestamp":1586908800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We sought to describe changes in demographic variables, process of care measures, and outcomes of patients treated in a regional ST\u2010segment elevation myocardial infarction (STEMI) program over the last 15\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We describe demographic variables, process of care measures, and outcomes of patients treated in the program in various 5\u2010year time periods: 2003\u20132007 (<jats:italic>n<\/jats:italic>\u00a0=\u20091,821), 2008\u20132012 (<jats:italic>n<\/jats:italic>\u00a0=\u20091,968), and 2013\u20132018 (<jats:italic>n<\/jats:italic>\u00a0=\u20092,223). The primary outcome measures were in\u2010hospital and 30\u2010day mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 6,012 STEMI patients treated from 2003 to 2018 we observed a significant increase in mean age at presentation (62\u2009\u00b1\u200914 to 64\u2009\u00b1\u200913\u2009years) and diabetes (14\u201322%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.01). The proportion of patients with cardiogenic shock (CS) and cardiac arrest (CA) pre\u2010PCI increased significantly from 9.5% to 11.1% and 8.5% to 12.7% (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.05), respectively. The median door\u2010to\u2010balloon (D2B) times decreased from 98 to 93\u2009min and total ischemic time decreased from 202 to 185\u2009min (all <jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.05). Despite increased patient complexity, the proportion of nontransfer and transfer patients achieving D2B times consistent with guideline recommendations remained unchanged (for nontransfer patients 79\u201382%, <jats:italic>p<\/jats:italic>\u00a0=\u2009.45 and for transfer patients 65\u201364%, <jats:italic>p<\/jats:italic>\u00a0=\u2009.34). Among all STEMI patients, in\u2010hospital mortality increased during the study period from 4.9 to 6.9% (<jats:italic>p<\/jats:italic>\u00a0=\u2009.007) but remained stable (&lt;2%) when CA and CS patients were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Over the last 15\u2009years, short\u2010term STEMI mortality has increased despite improvements in care delivery metrics. Patients with CA and\/or CS now represent 10% of STEMI patients and are responsible for 80% of deaths. Therefore, efforts to improve STEMI mortality, and metrics for assessing STEMI programs, should focus on these patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28901","type":"journal-article","created":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T21:06:48Z","timestamp":1586984808000},"page":"1109-1117","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Temporal changes in patient characteristics and outcomes in ST\u2010segment elevation myocardial infarction 2003\u20132018"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3715-8082","authenticated-orcid":false,"given":"Santiago","family":"Garcia","sequence":"first","affiliation":[{"name":"Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian W.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross","family":"Garberich","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1123-0533","authenticated-orcid":false,"given":"Timothy D.","family":"Henry","sequence":"additional","affiliation":[{"name":"The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven M.","family":"Bradley","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9416-9701","authenticated-orcid":false,"given":"Emmanouil S.","family":"Brilakis","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nickolas","family":"Burke","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan J.","family":"Chavez","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Eckman","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"G\u00f6ssl","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Mooney","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc C.","family":"Newell","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil K.","family":"Poulose","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Foundation at Abbott Northwestern 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