ED visits for STEMI declined in recent years

The number of patients presenting to EDs for STEMI decreased from 2006 to 2011 across all age groups and regions in the United States, according to data presented at the American Heart Association Scientific Sessions.

Researchers performed a cross-sectional analysis incorporating data collected from the Nationwide ED Sample on adults admitted for STEMI from 2006 to 2011. STEMI incidence was stratified according to patient age, region and year.

In total, 1,548,634 ED visits due to STEMI occurred from 2006 to 2011, with a mean of 258,106 patients per year and an annual incidence of 8.5 cases per 10,000 adults.

The annual number of visits decreased during the study period, from 300,466 in 2006 to 227,343 in 2011. The incidence rate of ED visits due to STEMI similarly decreased, from 10.1 per 10,000 adults in 2006 to 7.3 per 10,000 adults in 2011.

The lower incidence of ED presentation of STEMI persisted across all evaluated age groups. STEMI was most prevalent among patients aged at least 85 years. The researchers noted that the observed decrease in incidence over time was most pronounced for this age group.

By region, the mean incidence rate of STEMI was highest in the Midwest (10 cases per 10,000 adults) and lowest in the West (6.6 per 10,000 adults).

The researchers offered several possible explanations for the decline in ED visits due to STEMI, including improvement in acute and long-term CVD management and the practice of bringing patients directly to cardiac catheterization labs to reduce time to reperfusion. However, the observed decrease in ED visits for STEMI “could have important implications for the quality of care delivered to these patients in the ED,” and may suggest the need for reassessment of how resources are distributed for CVD care, according to the researchers.

“If the overall number of severe heart attack patients seen in the ED decreases, then health care providers will have less experience caring for these patients, which could lead to delays in recognition for an illness that is highly dependent upon prompt diagnosis and treatment,” Michael Ward, MD, MBA, assistant professor of emergency medicine at Vanderbilt University, said in a press release. “It is important that we continue national surveillance on these patients in order to guide health care resource allocation and ensure all of these time-sensitive patients are recognized and treated appropriately.”

For more information:

Ward MJ. Abstract #15553. Presented at: American Heart Association Scientific Sessions; Nov. 15-19, 2014; Chicago.

Ward MJ. Am J Cardiol. 2014;doi:10.1016/j.amjcard.2014.10.020.

Disclosure: The researchers report no relevant financial disclosures.