ArticleClinical cardiology2014
Regional variation across the United States in management and outcomes of ST-elevation myocardial infarction: analysis of the 2003 to 2010 nationwide inpatient sample database.
Article in Clinical cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Factors Associated with Invasive Coronary Angiography Use in Type 2 Myocardial Infarction: A Systematic Review with Narrative Synthesis.Journal of clinical medicine · 2026Review
- Patterns and outcomes of invasive management of type 2 myocardial infarction in the United States.Coronary artery disease · 2022Article
- Regional variations in the process of care for patients undergoing percutaneous coronary intervention in Japan.The Lancet regional health. Western Pacific · 2022Article
- Between-Center Variation in Outcome After Endovascular Treatment of Acute Stroke: Analysis of Two Nationwide Registries.Circulation. Cardiovascular quality and outcomes · 2022Article
- Regional Variation in the Management and Outcomes of Acute Myocardial Infarction With Cardiogenic Shock in the United States.Circulation. Heart failure · 2020Article
- Association Between Ambulatory Care Utilization and Coronary Artery Disease Outcomes by Race/Ethnicity.Journal of the American Heart Association · 2019Article
- Characteristics, Prevention, and Management of Cardiovascular Disease in People Living With HIV: A Scientific Statement From the American Heart Association.Circulation · 2019Review
- Racial/ethnic disparities among Asian Americans in inpatient acute myocardial infarction mortality in the United States.BMC health services research · 2018Article
- Regional Variation in Postoperative Myocardial Infarction in Patients Undergoing Vascular Surgery in the United States.Annals of vascular surgery · 2017Observational
- Patient and hospital determinants of primary percutaneous coronary intervention in England, 2003-2013.Heart (British Cardiac Society) · 2016Article
- Article
- Assessing the Quality of Care for Patients With Acute Myocardial Infarction in China.Clinical cardiology · 2015Article
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8 authors.
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Abstract
backgroundRegional differences in the treatment and outcomes of patients with ST-elevation myocardial infarction (STEMI) within the United States remain poorly understood. HYPOTHESIS: Treatment choice and outcomes in patients with STEMI differ between regions within the United States.
methodsWe used the 2003 to 2010 Nationwide Inpatient Sample databases to identify all patients age ≥ 40 years hospitalized with STEMI. Patients were divided into 4 groups according to region: Northeast, Midwest, South, and West. Multivariable logistic regression was used to identify differences in treatment choice and outcomes (in-hospital mortality, acute stroke, and cardiogenic shock) among the 4 regions.
resultsOf 1,990,486 patients age ≥ 40 years with STEMI, 350,073 (17.6%) were hospitalized in the Northeast, 483,323 (24.3%) in the Midwest, 784,869 (39.4%) in the South, and 372,222 (18.7%) in the West. Compared with the Northeast, patients in the Midwest, South, and West were less likely to receive medical therapy alone and more likely to receive percutaneous coronary intervention and coronary artery bypass grafting. Risk-adjusted in-hospital mortality was higher in the Midwest (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.05-1.09, P <0.001), South (OR: 1.03, 95% CI: 1.01-1.05, P = 0.001), and West (OR: 1.06, 95% CI: 1.04-1.08, P <0.001), as compared with the Northeast. When adjusted further for regional variation in treatment selection, risk-adjusted in-hospital mortality was even higher in the Midwest, West, and South.
conclusionsDespite higher reperfusion and revascularization rates, STEMI patients in the Midwest, West, and South have paradoxically higher risk-adjusted in-hospital mortality as compared with patients in the Northeast.
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