Association of Changes in Clinical Characteristics and Management With Improvement in Survival Among Patients With ST-Elevation Myocardial Infarction

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Abstract
Several sources, including registries specific to acute myocardial infarction (AMI) and large administrative or billing databases, have shown a decrease in mortality in patients with ST-segment elevation myocardial infarction (STEMI) over the past 10 to 15 years.1-9 This decline is usually attributed to increased use and improved delivery of reperfusion therapy, in particular primary percutaneous coronary intervention (PCI). We hypothesized that, beyond primary PCI, other factors such as temporal changes in patient population characteristics may account for part of the observed reduction in mortality of patients with STEMI.