{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T13:26:07Z","timestamp":1783689967616,"version":"3.55.0"},"reference-count":36,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T00:00:00Z","timestamp":1687305600000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015345","name":"ZOLL Medical Corporation","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100015345","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,6,2]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We sought to compare the temporal trends in the incidence of death and rehospitalisation for congestive heart failure (CHF) following anterior ST-elevation myocardial infarction (STEMI) in a Medicare cohort of beneficiaries treated with primary percutaneous coronary intervention (PCI) in 2005 (n=1479) with those treated in 2016 through quarter (Q) 2 of 2017 (n=22\u2009432).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This retrospective analysis examined outcomes using both descriptive and regression analysis to control for differences in patient clinical characteristics over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>The primary outcomes are 1\u2009year and 2\u2009year rates of mortality and re-hospitalisation for CHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 1\u2009year mortality rate was numerically higher in the 2016 cohort at 10.3% (95% CI 9.9 to 10.7) versus 8.9% (CI 7.4 to 10.3; p=0.068). The 2\u2009year mortality rate was significantly higher in the 2016 cohort at 14.5% (CI 13.9 to 15.1) versus 11.4% (CI 9.2 to 13.6; p&lt;0.01). The 1\u2009year rehospitalisation for CHF was lower in the 2016 cohort at 10.6% (CI 10.0 to 11.2) versus 16.7% (CI 14.0 to 19.4; p&lt;0.001), but the 2\u2009year rate was not significantly different at 19.3% (CI 17.7 to 20.9) versus 20.7% (CI 16.4 to 24.9; p=0.55). After adjustment for covariates with two models, the 1\u2009year mortality increased by 2.3% (CI 0.8 to 3.7; p&lt;0.01) and 4.1% (CI 2.6 to 5.6; p&lt;0.001) in the 2016 cohort. The 2\u2009year adjusted mortality also increased by 4.2% (CI 2.0 to 6.4; p&lt;0.001) and 6.5% (CI 4.2 to 8.7; p&lt;0.001) in the 2016 cohort. The risk adjusted trends for rehospitalisation for CHF were similar to the unadjusted findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite prior improvements in STEMI outcomes in the reperfusion era related to the broad adoption of timely PCI, there is a persistent high mortality and CHF burden in Medicare beneficiaries with anterior STEMI. New strategies that address reperfusion injury and enhance myocardial salvage are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-070210","type":"journal-article","created":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T09:44:29Z","timestamp":1687340669000},"page":"e070210","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Persistent mortality and heart failure burden of anterior ST-segment elevation myocardial infarction following primary percutaneous coronary intervention: real-world evidence from the US Medicare Data Set"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8709-0392","authenticated-orcid":false,"given":"Jack","family":"Martin","sequence":"first","affiliation":[{"name":"Department of Scientific Affairs, Main Line Health System, Sharpe-Strumia Research Foundation of the Bryn Mawr Hospital, Newtown Square, PA, USA"},{"name":"Department of Drug Development Solutions, ICON plc, Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,6,21]]},"reference":[{"key":"2025121604250951000_13.6.e070210.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31678-6"},{"key":"2025121604250951000_13.6.e070210.2","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.013542","article-title":"Trends in acute myocardial infarction by race and Ethnicity","volume":"9","author":"Chi","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"2025121604250951000_13.6.e070210.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.030798"},{"key":"2025121604250951000_13.6.e070210.4","doi-asserted-by":"crossref","first-page":"3066","DOI":"10.1093\/eurheartj\/ehx569","article-title":"From Eisenhower\u2019s heart attack to modern management: a true success story","volume":"38","author":"L\u00fcscher","year":"2017","journal-title":"Eur Heart J"},{"key":"2025121604250951000_13.6.e070210.5","doi-asserted-by":"crossref","first-page":"3056","DOI":"10.1093\/eurheartj\/ehx515","article-title":"Improved outcomes in patients with ST-elevation myocardial infarction during the last 20 years are related to implementation of evidence-based treatments: experiences from the SWEDEHEART Registry 1995\u20132014","volume":"38","author":"Szummer","year":"2017","journal-title":"Eur Heart J"},{"key":"2025121604250951000_13.6.e070210.6","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.017159","article-title":"Trends in Short- and long-term ST-segment-elevation myocardial infarction prognosis over 3 decades: A Mediterranean population-based ST-segment-elevation myocardial infarction Registry","volume":"9","author":"Garc\u00eda-Garc\u00eda","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"2025121604250951000_13.6.e070210.7","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2016-000405","article-title":"Mortality pattern and cause of death in a long-term follow-up of patients with STEMI treated with primary PCI","volume":"3","author":"Doost Hosseiny","year":"2016","journal-title":"Open Heart"},{"key":"2025121604250951000_13.6.e070210.8","doi-asserted-by":"publisher","DOI":"10.4330\/wjc.v9.i5.407"},{"key":"2025121604250951000_13.6.e070210.9","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1093\/cvr\/cvx049","article-title":"Novel targets and future strategies for acute cardioprotection: position paper of the European society of cardiology working group on cellular biology of the heart","volume":"113","author":"Hausenloy","year":"2017","journal-title":"Cardiovasc Res"},{"key":"2025121604250951000_13.6.e070210.10","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.004046"},{"key":"2025121604250951000_13.6.e070210.11","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.897249"},{"key":"2025121604250951000_13.6.e070210.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1505489"},{"key":"2025121604250951000_13.6.e070210.13","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199801000-00004"},{"key":"2025121604250951000_13.6.e070210.14","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.046677"},{"key":"2025121604250951000_13.6.e070210.15","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.4244\/EIJ-D-21-00192","article-title":"Temporal trends in outcomes after percutaneous coronary intervention: a systematic review of 66,327 patients from 25 all-Comers trials","volume":"17","author":"Asano","year":"2021","journal-title":"EuroIntervention"},{"key":"2025121604250951000_13.6.e070210.16","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2019-001214","article-title":"Contemporary trends in use of mechanical circulatory support in patients with acute MI and cardiogenic shock","volume":"7","author":"Helgestad","year":"2020","journal-title":"Open Heart"},{"key":"2025121604250951000_13.6.e070210.17","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.3555","article-title":"Assessment of completeness of hospital readmission rates reported in Medicare advantage contracts\u2019 Healthcare effectiveness data and information set","volume":"3","author":"Kim","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2025121604250951000_13.6.e070210.18","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.5600\/mmrr.004.01.b03","article-title":"Evaluating whether changes in utilization of hospital outpatient services contributed to lower Medicare readmission rate","volume":"4","author":"Gerhardt","year":"2014","journal-title":"Medicare Medicaid Res Rev"},{"key":"2025121604250951000_13.6.e070210.19","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.cardfail.2021.12.017","article-title":"Economic issues in heart failure in the United States","volume":"28","author":"Heidenreich","year":"2022","journal-title":"J Card Fail"},{"key":"2025121604250951000_13.6.e070210.20","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.cardfail.2021.09.001","article-title":"Temporal trends in post myocardial infarction heart failure and outcomes among older adults","volume":"28","author":"Kochar","year":"2022","journal-title":"J Card Fail"},{"key":"2025121604250951000_13.6.e070210.21","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.22190","article-title":"Temporal trends in heart failure incidence among Medicare beneficiaries across risk factor Strata, 2011 to 2016","volume":"3","author":"Khera","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2025121604250951000_13.6.e070210.22","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmw145"},{"key":"2025121604250951000_13.6.e070210.23","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2104508"},{"key":"2025121604250951000_13.6.e070210.24","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.117.004873","article-title":"National burden of heart failure events in the United States, 2006 to 2014","volume":"11","author":"Jackson","year":"2018","journal-title":"Circ Heart Fail"},{"key":"2025121604250951000_13.6.e070210.25","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.1016\/j.ijcard.2012.05.064","article-title":"Comparison of long-term outcomes of STEMI and NSTE-ACS after coronary Stent placement: an analysis in a real world BMS and DES population","volume":"167","author":"van Leeuwen","year":"2013","journal-title":"Int J Cardiol"},{"key":"2025121604250951000_13.6.e070210.26","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00548-6"},{"key":"2025121604250951000_13.6.e070210.27","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-307855"},{"key":"2025121604250951000_13.6.e070210.28","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw224"},{"key":"2025121604250951000_13.6.e070210.29","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra071667"},{"key":"2025121604250951000_13.6.e070210.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.01.069"},{"key":"2025121604250951000_13.6.e070210.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.09.086"},{"key":"2025121604250951000_13.6.e070210.32","first-page":"1021","article-title":"Update for cardioprotective strategies for STEMI","volume":"6","author":"Kloner","year":"2021","journal-title":"JACC: Basic to Translational Science"},{"key":"2025121604250951000_13.6.e070210.33","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.108.840066"},{"key":"2025121604250951000_13.6.e070210.34","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.117.005968","article-title":"Delayed care and mortality among women and men with myocardial infarction","volume":"6","author":"Bugiardini","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"2025121604250951000_13.6.e070210.35","first-page":"e46","article-title":"Recent\u2002national trends\u2002in\u2002acute\u2002myocardial\u2002infarction\u2002hospitalizations\u2002in\u2002Medicare","volume":"26","author":"Sack","year":"2015","journal-title":"Epidemiology"},{"key":"2025121604250951000_13.6.e070210.36","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.1938","article-title":"Twenty-year trends in outcomes for older adults with acute myocardial infarction in the United States","volume":"2","author":"Krumholz","year":"2019","journal-title":"JAMA Netw Open"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-070210","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:25:19Z","timestamp":1765887919000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-070210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,6,21]]},"published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1136\/bmjopen-2022-070210"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-070210","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}