Special Articles: NRMI 1990-2006Trends in presenting characteristics and hospital mortality among patients with ST elevation and non-ST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006
Section snippets
Data source
The NRMI was an industry-sponsored, voluntary, prospective observational study. No experimental intervention was required for registry participation; only routine and actual patient management was documented. Details of the NRMI data collection process have been published previously.5 Registry coordinators at participating hospitals used a standardized manual of instructions and definitions to collect data on consecutive patients with AMI. A centralized data center instituted systematic range
Patient population and participating hospitals
From 1990 to 2006, 2,515,106 patients were enrolled in NRMI 1 to 5 at 2,157 unique hospitals. Of these patients, 1,950,561 had evidence of myocardial ischemia on admission and constituted our study population. Over time, the proportion of hospitals with capabilities for revascularization increased as did the proportion of hospitals with smaller bed size (Table I). To account for this variability, subsequent data have been adjusted or “weighted” for hospital facility type (invasive capabilities)
Discussion
The principal findings of this analysis of temporal trends from 1990 to 2006 in a large, contemporary registry of AMI are that the prevalence of patients with NSTEMI has risen in proportion to that of patients with STEMI and that patients are presenting with higher risk for adverse outcome from AMI. However, despite the increasing risk profile, unadjusted hospital mortality among patients not transferred out of the registry hospitals fell by >39% from 1994 to 2006, and mortality adjusted for
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2022, Current Problems in CardiologyCitation Excerpt :An estimated 38% of patients who presented to the hospital with an acute coronary syndrome reportedly had STEMI.3 While the overall outcomes of STEMI have improved over the years due to advances in STEMI treatment1,4, STEMI remains a notable health problem with significant morbidity and mortality. An estimated $12.1 billion US dollars were spent on STEMI associated hospitalizations in the United States in 2013, putting a significant economic impact on the US healthcare system.5
Genentech Inc (San Francisco, CA) provided financial support to the study.
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See Appendix A for author disclosure statements.