Surveying the Literature: Synopsis of Recent Key Publications

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Mazzella AJ, Abisogun AA, Caughey M, Dai X. Mortality rates and length of stay in patients with acute non-ST segment elevation myocardial infarction hospitalized for noncardiac conditions on surgical versus nonsurgical services. Am J Cardiol. 2017;120:1472–1478.
In this single-center retrospective analysis, Mazzella et al identified 302 patients hospitalized on surgical versus nonsurgical services for noncardiac conditions, who experienced non-ST segment elevation myocardial infarctions (NSTEMI) (108 others experienced ST segment elevation myocardial infarctions and were not further discussed). About equal numbers of NSTEMI occurred on surgical and nonsurgical services, and 19% died in hospital. Thirty-three percent underwent cardiac catheterization, and 56% of these patients received revascularization. Patients undergoing cardiac catheterization had a lower in-hospital mortality (6% vs 25%) and shorter length of stay. Patients on surgical services were more likely to receive a cardiology consultation (96% vs 62%) and catheterization (41% vs 24%). Cardiac catheterization was not done because of perceived high risk for complications (bleeding or kidney injury) (32%), critical primary condition (28%), patient declined (21%), or cardiology service not involved (13%). Inpatient NSTEMI has a high mortality that may be lower if cardiac catheterization is performed.
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