Temporal Trends in the Clinical Acuity of Patients with ST-Segment Elevation Myocardial Infarction

During a period that corresponds to improvement in STEMI quality of care, risk-adjusted in-hospital mortality declined. An increase in comorbidities, and more importantly in the proportion of patients presenting with extreme-risk features, may explain the overall “null” effect regarding in-hospital mortality despite improvements in timely reperfusion.