{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T19:49:24Z","timestamp":1776887364790,"version":"3.51.2"},"reference-count":10,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,11,7]],"date-time":"2020-11-07T00:00:00Z","timestamp":1604707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In\u2010hospital ST\u2010elevation myocardial infarction (STEMI) is associated with a higher mortality rate than out\u2010of\u2010hospital STEMI. Quality measures and universal protocols for treatment of in\u2010hospital STEMI do not exist, likely contributing to delays in recognition and treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>To analyze differences in mortality among three subsets of patients who develop in\u2010hospital STEMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a multicenter, retrospective observational study of patients who developed in\u2010hospital STEMI at six United States medical centers between 2008 and 2017. Patients were stratified into three groups: (1) cardiac, (2) periprocedure, or (3) noncardiac\/nonpostprocedure. Outcomes examined include time from electrocardiogram (ECG) acquisition to cardiac catheterization lab arrival (ECG\u2010to\u2010CCL) and survival to discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 184 patients with in\u2010hospital STEMI (mean age 68.7\u2009years, 58.7% male). Group 1 (cardiac) patients had a shorter average ECG\u2010to\u2010CCL time (69\u2009minutes) than group 2 (periprocedure, 215\u2009minutes) and group 3 (noncardiac\/nonpostprocedure, 199\u2009minutes). Compared to group 1, survival to discharge was lower for group 2 (OR 0.33, <jats:italic>P<\/jats:italic> = .102) and group 3 (OR 0.20, <jats:italic>P<\/jats:italic> = .016). After adjusting for prespecified covariates, the relationship between group and survival showed a similar trend but did not reach statistical significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients who develop in\u2010hospital STEMI in the context of a preceding procedure or noncardiac illness appear to have longer reperfusion times and higher in\u2010hospital mortality than patients admitted with cardiac diagnoses. Larger studies are warranted to further investigate these observations. Health systems should place an increased emphasis on developing quality metrics and implementing quality improvement initiatives to improve outcomes for in\u2010hospital STEMI.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23480","type":"journal-article","created":{"date-parts":[[2020,11,7]],"date-time":"2020-11-07T10:31:09Z","timestamp":1604745069000},"page":"1555-1561","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Mortality differences among patients with i<scp>n\u2010hospital ST\u2010elevation<\/scp> myocardial infarction"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7811-8063","authenticated-orcid":false,"given":"Negeen","family":"Shahandeh","sequence":"first","affiliation":[{"name":"University of California Los Angeles  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuming","family":"Dai","sequence":"additional","affiliation":[{"name":"University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Jaski","sequence":"additional","affiliation":[{"name":"Sharp Memorial Hospital San Diego  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravi","family":"Dave","sequence":"additional","affiliation":[{"name":"University of California Los Angeles  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Boston University Medical Center  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Denktas","sequence":"additional","affiliation":[{"name":"The Michael E. DeBakey VA Medical Center  Houston Texas USA"},{"name":"Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn","family":"Levine","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Markovic","sequence":"additional","affiliation":[{"name":"University of California Los Angeles  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Sidney C.","family":"Smith","sequence":"additional","affiliation":[{"name":"University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcella Calfon","family":"Press","sequence":"additional","affiliation":[{"name":"University of California Los Angeles  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2017.5356"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.15236"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000004"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2015.165"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2007.10.006"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.11.003"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.174477"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.12.072"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005568"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.199"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.23480","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/clc.23480","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.23480","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T17:30:03Z","timestamp":1693416603000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.23480"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,7]]},"references-count":10,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1002\/clc.23480"],"URL":"https:\/\/doi.org\/10.1002\/clc.23480","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,7]]},"assertion":[{"value":"2020-07-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}