{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T02:01:42Z","timestamp":1649037702303},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"5-6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>ST elevation myocardial infarction (STEMI) is a high acuity diagnosis that requires prompt recognition and developed system responses to reduce morbidity and mortality. There is a paucity of literature describing active duty (AD) military personnel with STEMI syndromes at military treatment facilities (MTFs). This study aims to describe AD military members with STEMI diagnoses, military treatment facility management, and subsequent military dispositions observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We performed a single-center, retrospective review of all STEMI diagnoses at San Antonio Military Medical Center (SAMMC) from January 2008 to June 2018. Patients met inclusion in the analysis if they were (1) AD personnel in the United States Air Force (USAF) or United States Army (USA) and (2) presented with electrocardiogram findings and cardiac biomarkers diagnostic of a STEMI diagnosis. ASCVD and STEMI diagnoses were confirmed by board certified interventional cardiologists with coronary angiography. The 2017 American College of Cardiology (ACC) STEMI clinical performance and quality measures were used as the standard of care metrics for our case reviews.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 236 patients were treated for STEMI at SAMMC during the study period. Eight (3.4%) of these cases met inclusion criteria of being AD status at the time of diagnosis. Five (63%) of the AD STEMI diagnoses were USA members, three (37%) were USAF members, 50% were Caucasian, and 100% were male sex. The average age and body mass index were 46.3\u00a0\u00b1\u00a05.5\u00a0years old and 28.5\u00a0\u00b1\u00a03.1\u00a0kg\/m 2, respectively. Preexisting cardiovascular risk factors were present in six (75%) of the individuals with hypertension being most common (63%). The eight patients had a baseline average low-density lipoprotein cholesterol of 110\u00a0\u00b1\u00a039\u00a0mg\/dL, total cholesterol of 180\u00a0\u00b1\u00a049\u00a0mg\/dL and calculated 10-year risk of atherosclerotic cardiovascular disease (ASCVD) 3.9\u00a0\u00b1\u00a01.6%. 100% of patients underwent primary percutaneous coronary intervention (PCI) within 90\u00a0minutes of presentation (average door-to-balloon time 59.3\u00a0\u00b1\u00a024\u00a0min). Single-vessel disease was found in all eight patients and seven of them underwent drug-eluting stent placement (average number of stents 2\u00a0\u00b1\u00a01.5). Performance and quality measures were met in all applicable categories including door-to-balloon times, discharge medical therapies, and cardiac rehabilitation enrollments for 100% AD personnel. Reported adverse events included two stent thromboses and two vascular complications. Three of eight individuals (37.5%) were diagnosed with behavioral health disorders secondary to their acute coronary syndrome. Medical retirement secondary to STEMI diagnosis occurred in 87.5% of subjects and all study personnel medically retired within 24\u00a0months (average 12.8\u00a0\u00b1\u00a07.9\u00a0months).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>AD personnel represent a small minority of MTF STEMI diagnoses and present with lower risk cardiovascular profiles. AD personnel received standard STEMI management compared to national performance measures, and were deployment ineligible after STEMI diagnoses. Further studies are needed to definitively explore the appropriate military dispositions for members with STEMI diagnoses and acute coronary syndromes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usaa026","type":"journal-article","created":{"date-parts":[[2020,4,17]],"date-time":"2020-04-17T12:35:57Z","timestamp":1587126957000},"page":"e638-e642","source":"Crossref","is-referenced-by-count":2,"title":["Active Duty Personnel With ST Elevation Myocardial Infarctions Are Deployment Ineligible Despite Receiving Standard Management"],"prefix":"10.1093","volume":"185","author":[{"given":"Andrew S","family":"Wilson","sequence":"first","affiliation":[{"name":"Division of Cardiology, San Antonio Military Medical Center, 3551 Roger Brooke Dr. San Antonio, TX 78234 The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Air Force, the Department of the Army or the Department"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A","family":"Watts","sequence":"first","affiliation":[{"name":"Division of Cardiology, San Antonio Military Medical Center, 3551 Roger Brooke Dr. San Antonio, TX 78234 The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Air Force, the Department of the Army or the Department"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelvin N V","family":"Bush","sequence":"first","affiliation":[{"name":"Division of Cardiology, San Antonio Military Medical Center, 3551 Roger Brooke Dr. San Antonio, TX 78234 The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Air Force, the Department of the Army or the Department"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,4,17]]},"reference":[{"issue":"3","key":"2020060909043281900_ref1","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/eurheartj\/ehy462","article-title":"Fourth universal definition of myocardial infarction (2018)","volume":"40","author":"Thygesen","year":"2019","journal-title":"Eur Heart J"},{"issue":"4","key":"2020060909043281900_ref2","first-page":"78","article-title":"ACCF\/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines","volume":"61","author":"O\u2019Gara","year":"2013","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"2020060909043281900_ref3","first-page":"38","article-title":"Heart Disease and Stroke Statistics-2016 Update: a report from the American Heart Association","volume":"133","author":"Mozaffarian","year":"2016","journal-title":"Circulation"},{"key":"2020060909043281900_ref4","first-page":"12","article-title":"Surveillance snapshot: acute myocardial infarction, active component","author":"Armed Forces Health Surveillance Center (AFHSC)","year":"2000-2009"},{"issue":"16","key":"2020060909043281900_ref5","doi-asserted-by":"crossref","first-page":"2048","DOI":"10.1016\/j.jacc.2017.06.032","article-title":"2017 AHA\/ACC clinical performance and quality measures for adults with ST-elevation and non\u2013ST-elevation myocardial infarction: a report of the American College of Cardiology\/American Heart Association Task Force on Performance Measures","volume":"70","author":"Jneid","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2020060909043281900_ref6","author":"The American College of Cardiology's Chest Pain - 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