Trends and Outcomes of Transferred Patients With ST-Elevation Myocardial Infarction from Acute Care Hospitals (from a Nationwide Analysis)

Because timely primary percutaneous coronary intervention (PPCI) is the preferred therapy for ST-segment elevation myocardial infarction (STEMI),1 there has been a substantial growth in the number of PPCI centers in the United States.2 Oftentimes, there remains a need for interhospital STEMI transfers from noncapable percutaneous coronary intervention (PCI) centers to PPCI centers, and it is unclear if such an expansion has led to a change in the real-world practice landscape for STEMI transfers.2 Thus, we aimed to explore trends and outcomes for STEMI transfers using the Nationwide Inpatient Sample (NIS) from 2008 to 2018. STEMI transfers versus nontransfers were matched in a 1:1 pattern using relevant variables (age, gender, length of stay, heart failure, atrial fibrillation, chronic kidney or lung disease, hypertension, diabetes mellitus, peripheral vascular disease, and history of coronary artery bypass grafting or stroke), and the standardized mean difference percent between the 2 groups was calculated with a cutoff point of 10%. A logistic regression analysis was conducted to explore predictors of mortality including variables that are clinically relevant or statistically significant on univariate analysis. p