Abstract
In-hospital ST-segment elevation myocardial infarction (STEMI) is a unique clinical entity with epidemiology, incidence, and outcomes distinct from that of out-of-hospital STEMI and has only within the past 10 years begun to receive increased attention and research. Patients with in-hospital STEMI are older, have more comorbidities, and more frequently have coagulopathies and contraindications for anticoagulation and fibrinolytic therapy. A standardized clinical definition of in-hospital STEMI is lacking. The objectives of this special communication are to (1) summarize the knowledge base regarding in-hospital STEMI; (2) review the challenges of diagnosis and treatment of patients with in-hospital STEMI; (3) present a standardized clinical definition for in-hospital STEMI; and (4) provide a quality improvement protocol to improve diagnosis, triage, and treatment of patients with in-hospital STEMI. Patients with in-hospital STEMI less frequently present with typical angina symptoms, and an electrocardiogram is often obtained owing to changes in clinical status, changes on telemetry, or a finding of elevated cardiac biomarker. The frequent nontypical presentations often lead to substantial delays in the diagnosis of STEMI. Only 3...Continue Reading
References
Jul 1, 1986·European Heart Journal·D Chamberlain, S Campbell
May 1, 1981·American Heart Journal·R W ZmyslinskiJ E Higgins
Jan 13, 1999·Circulation·M D CheitlinR M Zusman
Jun 7, 2000·Journal of the American College of Cardiology·R ZahnJ Senges
Jul 13, 2006·Archives of Internal Medicine·Charles MaynardStephan D Fihn
Jun 19, 2010·The New England Journal of Medicine·Robert W YehAlan S Go
Sep 11, 2012·Journal of the American College of Cardiology·Kristian ThygesenDaniel R Wagner
Nov 10, 2012·Arquivos brasileiros de cardiologia·Danielle Menosi GualandroBruno Caramelli
Apr 6, 2013·Journal of the American Heart Association·Xuming DaiGeorge A Stouffer
Dec 20, 2013·Circulation·Alan S GoUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Jan 7, 2014·Circulation·Ross F GarberichTimothy D Henry
May 16, 2014·Critical Pathways in Cardiology·Tyler RichmondGary L Schaer
Nov 17, 2014·JAMA : the Journal of the American Medical Association·Prashant KaulGeorge A Stouffer
Jun 3, 2015·European Journal of Internal Medicine·Paul ErneUNKNOWN AMIS Plus Investigators
Nov 4, 2015·Nature Reviews. Cardiology·Xuming DaiGeorge A Stouffer
Sep 23, 2016·JAMA Cardiology·Xuming DaiGeorge A Stouffer
Citations
Jan 19, 2019·JAMA Network Open·Steven M BradleyStephan D Fihn
Sep 27, 2019·Experimental and Therapeutic Medicine·Liyuan ZouChaoquan Peng
Nov 8, 2020·Clinical Cardiology·Negeen ShahandehMarcella Calfon Press
Jan 6, 2021·Journal of the American Heart Association·Melissa C CaugheyKunihiro Matsushita
Mar 13, 2021·The Journal of International Medical Research·Wenlan HuXingshan Zhao
Nov 18, 2020·Australasian Emergency Care·Gemma Berga CongostMaria Antonia Martinez Momblan
Jun 1, 2021·Interventional Cardiology Clinics·Alayn GoveaMitul P Patel
Aug 5, 2021·Resuscitation Plus·Anirudh KumarUmesh N Khot
Nov 2, 2021·Quality Management in Health Care·Andrew E LevyP Michael Ho