• Mohammed Uddin, Tanveer Mir, Amir Khalil, Anupamandeep Mehar, Eduardo Gomez-Pineiro, Mohammed Amir Babu, Mujeeb Sheikh, Ayman Soubani, Ghulam Saydain, and Luis Afonso.
• Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, Michigan. Electronic address: mohammed.uddin2@wayne.edu.
• J Emerg Med. 2022 Mar 1; 62 (3): 306-315.

BackgroundLiterature regarding trends in incidence and mortality of ST-elevation myocardial infarction (STEMI) in emergency departments (EDs) is limited.ObjectiveTo study the trends of incidence and mortality of STEMI.MethodsUsing the National Emergency Department Sample database in the United States, we identified all ED encounters for patients presenting with STEMI using International Classification of Diseases codes. A linear p-trend was used to assess the trends.ResultsOut of the 973 million ED encounters represented, 641,762 (65/100,000; mean age 69 [59-81] years, 35.8% female) adult patients were recorded with STEMI. Among the major complications associated with STEMI, a total of 49,401 (7.7%) had cardiac complications, which included acute heart failure (n = 9361, 1.6%), ventricular tachycardia or fibrillation (n = 12,267, 1.91%), conduction block (n = 20,165, 3.1%), and cardiogenic shock (n = 7608, 1.2%). There were 5675 (0.9%) patients recorded with cerebrovascular events, which included acute ischemic stroke among 5205 (0.8%) patients and 470 (0.1%) with transient ischemic attack. Acute kidney injury was recorded for 10,082 (1.6%) patients. The trend for incidence of STEMI in the ED had decreased from 7.76/10,000 in 2011 to 4.07/10,000 in 2018 (linear p-trend 0.0006). However, the yearly mortality of STEMI related to ED encounters had remained relatively steady: 7.56% in 2011 to 7.50% in 2018 (linear p-trend 0.2364).ConclusionDespite the fact that the number of patients presenting to the ED with STEMI has been decreasing, the mortality trends have remained steady. Further research of in-hospital STEMI may yield opportunities to reduce the risk of complications, improve patient outcomes and decrease health care burden.Copyright © 2021 Elsevier Ltd. All rights reserved.

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