TCT-1083 Association of Weekend Admission With Clinical Outcomes and Invasive Management in ST-Elevation Myocardial Infarction: A National Cohort Analysis

Document Type

Conference Proceeding

Publication Date

10-28-2025

Publication Title

J Am Coll Cardiol

Abstract

Background: ST-elevation myocardial infarction (STEMI) requires urgent revascularization to improve outcomes. The “weekend effect”—worse outcomes for weekend admissions—has been observed across various conditions, but its impact on all-comer STEMI hospitalizations remains unclear. Prior studies have focused on those receiving prompt PCI; less is known about overall access and outcomes. This study assesses whether weekend admission independently affects treatment and clinical outcomes in all STEMI admissions. Methods: We analyzed the 2017–2022 National Inpatient Sample for adults (≥18 years) with a primary STEMI diagnosis. Weekend admission was identified via the AWEEKEND variable. The primary outcome was in-hospital mortality. Secondary outcomes included cardiogenic shock, AKI, vasopressor use, sepsis, CVA, ICU admission, cardiac arrest, PCI and CABG (within 24h or overall), and mechanical circulatory support. Weighted logistic regression adjusted for patient and hospital factors. Results: Among 1.5 million STEMI admissions (25.9% weekend), weekend admission was linked to higher mortality (aOR 1.026), shock, AKI, sepsis, CVA, ICU use, and arrest (all p < 0.05). Odds of PCI within 24h, CABG, and any revascularization were lower (all p < 0.001). No differences were found in bleeding, ECMO, or balloon pump use. Impella use was slightly lower. [Formula presented] Conclusion: Weekend STEMI admission remains associated with worse outcomes and reduced revascularization. System-wide strategies are needed to close these gaps. Categories: CORONARY: Acute Coronary Syndromes

Volume

86

Issue

17

First Page

B462

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