{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T06:05:45Z","timestamp":1793340345628,"version":"4.5.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,3,17]]},"abstract":"\n Background<\/jats:title>\n \n Hospitals in the United States vary in their use of intensive care units (\n ICU<\/jats:styled-content>\n s) for hemodynamically stable patients with non\u2013\n ST<\/jats:styled-content>\n \u2010segment\u2013elevation myocardial infarction (\n NSTEMI<\/jats:styled-content>\n ). The association between\n ICU<\/jats:styled-content>\n use and long\u2010term outcomes after\n NSTEMI<\/jats:styled-content>\n is unknown.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Using data from the National Cardiovascular Data Registry linked to Medicare claims, we identified 65\u00a0256\n NSTEMI<\/jats:styled-content>\n patients aged \u2265 65 years without cardiogenic shock or cardiac arrest on presentation between 2011 and 2014. We compared 1\u2010year medication non\u2010adherence, cardiovascular readmission, and mortality across hospitals by\n ICU<\/jats:styled-content>\n use using multivariable regression models. Among 520 hospitals, 154 (29.6%) were high\n ICU<\/jats:styled-content>\n users (>70% of stable\n NSTEMI<\/jats:styled-content>\n patients admitted to\n ICU<\/jats:styled-content>\n ), 270 (51.9%) were intermediate (30%\u201370%), and 196 (37.7%) were low (<30%). Compared with low\n ICU<\/jats:styled-content>\n usage hospitals, no differences were observed in the risks of 1\u2010year medication non\u2010adherence (adjusted odds ratio 1.08, 95%\n CI<\/jats:styled-content>\n , 0.97\u20131.21), mortality (adjusted hazard ratio 1.06, 95%\n CI<\/jats:styled-content>\n , 0.98\u20131.15), and cardiovascular readmission (adjusted hazard ratio 0.99, 95% CI, 0.95\u20131.04) at high usage hospitals. Patients hospitalized at intermediate\n ICU<\/jats:styled-content>\n usage hospitals had lower rates of evidence\u2010based therapy and diagnostic catheterization within 24\u00a0hours of hospital arrival, and higher risks of 1\u2010year mortality (adjusted hazard ratio 1.07, 95%\n CI<\/jats:styled-content>\n , 1.02\u20131.12) and medication non\u2010adherence (adjusted odds ratio 1.09, 95%\n CI<\/jats:styled-content>\n , 1.02\u20131.15) compared with low\n ICU<\/jats:styled-content>\n usage hospitals.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Routine\n ICU<\/jats:styled-content>\n use is unlikely to be beneficial for hemodynamically stable\n NSTEMI<\/jats:styled-content>\n patients; medication adherence, long\u2010term mortality, and cardiovascular readmission did not differ for high\n ICU<\/jats:styled-content>\n usage hospitals compared with hospitals with low\n ICU<\/jats:styled-content>\n usage rates.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.015179","type":"journal-article","created":{"date-parts":[[2020,3,15]],"date-time":"2020-03-15T09:06:10Z","timestamp":1584263170000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Association Between Intensive Care Unit Usage and Long\u2010Term Medication Adherence, Mortality, and Readmission Among Initially Stable Patients With Non\u2013ST\u2010Segment\u2013Elevation Myocardial Infarction"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9060-5307","authenticated-orcid":false,"given":"Alexander C.","family":"Fanaroff","sequence":"first","affiliation":[{"name":"Cardiovascular Outcomes, Quality and Evaluative Research Center, Leonard Davis Institute of Health Economics, and Cardiovascular Medicine Division University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita 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