Abstract 15553: The Incidence of Emergency Department Visits for ST-Elevation Myocardial Infarction is Decreasing in the U.S
Introduction: The incidence and longitudinal trends of patients with ST-elevation myocardial infarction (STEMI) presenting to U.S. emergency departments (EDs) are currently unknown. Efforts to streamline door-to-balloon times by ED bypass, as well as greater use of effective treatments for cardiovascular disease, may decrease ED STEMI presentation. These estimates play an essential role in hospital resource allocation strategies.
Hypothesis: The incidence of STEMIs presenting to EDs is decreasing.
Methods: We conducted a descriptive epidemiological analysis of STEMI visits to EDs between 2006 through 2011 using the Nationwide Emergency Department Sample data which is the largest source of U.S. ED data. We included adult ED visits with an ICD-9CM diagnosis of STEMI and calculated incidence rates for STEMI ED visits using U.S. census population data. Incidence calculations were stratified by age group, geographic region, and year.
Results: From 2006-2011, there was a mean of 258,106 STEMIs presenting to EDs per year, declining from 300,466 in 2006 to 227,343 in 2011. Incidence of ED STEMI visits per 10,000 adults declined from 10.1 (95% CI 9.8,10.8) in 2006 to 7.3 (95% CI 6.8,7.8) in 2011. The Midwest had the highest rate at 10.0 (95% CI 9.2,10.8) and the West had the lowest with 6.6 (95% CI 6.1,7.0). The incidence of STEMI decreased for all age groups (Figure) and regions during the study period.
Conclusions: We report the first national estimates of STEMI presentation to U.S. EDs, which demonstrate decreasing incidence across all age groups and all geographic regions between 2006 and 2011.
Author Disclosures: M.J. Ward: None. S. Kripalani: None. Y. Zhu: None. A.B. Storrow: None. R.S. Dittus: None. F.E. Harrell: None. W.H. Self: None.
- © 2014 by American Heart Association, Inc.