Coronary disease & ACSCohort study
Impact of In-Hospital STEMI on Reperfusion Times and Clinical Outcomes
- Registry-based comparison of patients presenting with STEMI at the time of hospital admission versus in-hospital STEMI
- National Cardiovascular Data Registry Chest Pain-MI Registry
- 2019 to 2022
- 670 hospitals
Authors' conclusion
Patients who experience in-hospital STEMI represent a high-risk group, with significantly longer times from the diagnostic ECG to primary percutaneous coronary intervention, more complications, and higher mortality.
Study context
- Population
- Patients with STEMI, preadmission or occurring during hospitalization for other indications3.8% in-hospital STEMI, 96.2% preadmission STEMI, from 670 hospitals
- Participants
- 112,590 patients
- Exposure
- In-hospital STEMI versus preadmission STEMI
Main finding
As reported in the abstract
Time from ECG to first device activation
Observational data: associations, not effects.
Further findings
Time from cath laboratory arrival to first device time
| Outcome | in-hospital STEMI | preadmission STEMI | adjusted odds ratio (95% CI) | P value | |
|---|---|---|---|---|---|
| Mortality | 25.9% | 5.6% | 5.7 (5.0–6.4) | P < 0.001 | |
| 0.10.31310Adjusted odds ratio (log scale) |
Baseline characteristics
median age in-hospital STEMI 67 · preadmission STEMI 63 years
diabetic
congestive heart failure
- Time from cath laboratory arrival to first device time: P <0.001; significantly longer for in-hospital STEMI
- Baseline characteristics: all P <0.001
Safety
Major bleeding, cardiogenic shock, cardiac arrest
major bleeding
cardiogenic shock
cardiac arrest
- Major bleeding, cardiogenic shock, cardiac arrest: all significantly higher in the in-hospital STEMI cohort (all P <0.001)
Original publication
Impact of In-Hospital STEMI on Reperfusion Times and Clinical Outcomes. Circ Cardiovasc Interv. Published 3 February 2026. doi:10.1161/circinterventions.125.015547
Summarised from the published abstract; every number is checked against it