{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T06:05:43Z","timestamp":1793340343827,"version":"4.5.0"},"reference-count":59,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,10,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Despite investments to improve quality of emergency care for patients with acute myocardial infarction (AMI), few studies have described national, real\u2010world trends in AMI care in the emergency department (ED). We aimed to describe trends in the epidemiology and quality of AMI care in US EDs over a recent 11\u2010year period, from 2005 to 2015.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We conducted an observational study of ED visits for AMI using the National Hospital Ambulatory Medical Care Survey, a nationally representative probability sample of US EDs. AMI visits were classified as ST\u2010segment\u2013elevation myocardial infarction (STEMI) and non\u2010STEMI. Outcomes included annual incidence of AMI, median ED length of stay, ED disposition type, and ED administration of evidence\u2010based medications. Annual ED visits for AMI decreased from 1\u00a0493\u00a0145 in 2005 to 581\u00a0924 in 2015. Estimated yearly incidence of ED visits for STEMI decreased from 1\u00a0402\u00a0768 to 315\u00a0813. The proportion of STEMI sent for immediate, same\u2010hospital catheterization increased from 12% to 37%. Among patients with STEMI sent directly for catheterization, median ED length of stay decreased from 62 to 37\u00a0minutes. ED administration of antithrombotic and nonaspirin antiplatelet agents rose for STEMI (23%\u201331% and 10%\u201327%, respectively).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">National, real\u2010world trends in the epidemiology of AMI in the ED parallel those of clinical registries, with decreases in AMI incidence and STEMI proportion. ED care processes for STEMI mirror evolving guidelines that favor high\u2010intensity antiplatelet therapy, early invasive strategies, and regionalization of care.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.017208","type":"journal-article","created":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T09:08:34Z","timestamp":1602580114000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4191-2976","authenticated-orcid":false,"given":"Akshay","family":"Pendyal","sequence":"first","affiliation":[{"name":"Novant Health Heart and Vascular Institute Charlotte NC"},{"name":"National Clinician Scholars Program Yale School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3594-600X","authenticated-orcid":false,"given":"Craig","family":"Rothenberg","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Yale School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean E.","family":"Scofi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Yale School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2046-127X","authenticated-orcid":false,"given":"Harlan M.","family":"Krumholz","sequence":"additional","affiliation":[{"name":"National Clinician Scholars Program Yale School of Medicine New Haven CT"},{"name":"Center for Outcomes Research and Evaluation Yale\u2013New Haven Hospital New Haven CT"},{"name":"Section of Cardiovascular Medicine Department of Internal Medicine Yale School of Medicine New Haven CT"},{"name":"Department of Health Policy and Management Yale School of Public Health New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9640-7133","authenticated-orcid":false,"given":"Basmah","family":"Safdar","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Yale School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel P.","family":"Dreyer","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Yale School of Medicine New Haven CT"},{"name":"Center for Outcomes Research and Evaluation Yale\u2013New Haven Hospital New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8248-0567","authenticated-orcid":false,"given":"Arjun K.","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"National Clinician Scholars Program Yale School of Medicine New Haven CT"},{"name":"Department of Emergency Medicine Yale School of Medicine New Haven CT"},{"name":"Center for Outcomes Research and Evaluation Yale\u2013New Haven Hospital New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.1938"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.044107"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000358"},{"key":"e_1_3_1_5_2","first-page":"e67","article-title":"Heart disease and stroke statistics\u20102018 update: a report from the American Heart Association","author":"Benjamin EJ","year":"2018","unstructured":"Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, et al. 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