TCT-1082 Impact of Weekend Admission on Outcomes in STEMI Patients Undergoing Early Percutaneous Coronary Intervention: A National Retrospective Cohort Study

Document Type

Conference Proceeding

Publication Date

10-28-2025

Publication Title

J Am Coll Cardiol

Abstract

Background: ST-elevation myocardial infarction (STEMI) is a time-sensitive emergency requiring rapid reperfusion, usually via percutaneous coronary intervention (PCI). Despite improvements in door-to-balloon times, concerns remain about the “weekend effect,” where patients admitted on weekends may experience delays and worse outcomes. Limited data exist on whether this effect persists among STEMI patients undergoing PCI within 24 hours. This study evaluated whether weekend admission independently impacts in-hospital outcomes in this population. Methods: We used the 2017–2022 National Inpatient Sample (NIS) to identify adults with a primary diagnosis of STEMI who underwent PCI within 24 hours. The exposure was weekend admission (AWEEKEND). The primary outcome was in-hospital mortality. Secondary outcomes included cardiogenic shock, acute kidney injury (AKI), vasopressor use, sepsis, CVA, ICU admission, arrest, CABG, IABP, Impella, and ECMO. Of 117,462 patients, 28,632 (24.4%) were weekend admissions. We used survey-weighted logistic regression to adjust for patient, clinical, and hospital factors. Results: Weekend admission was associated with higher mortality (aOR 1.204; CI 1.124–1.29; p < 0.001), cardiogenic shock (aOR 1.189), AKI (aOR 1.163), vasopressor use (aOR 1.138), sepsis (aOR 1.136), CVA (aOR 1.302), ICU admission (aOR 1.17), and cardiac arrest (aOR 1.215). No differences were found for transfusion, GI bleeding, CABG, Impella, or ECMO. [Formula presented] Conclusion: Weekend admission was independently associated with worse outcomes despite early PCI, suggesting persistent disparities in STEMI care. Categories: CORONARY: Acute Coronary Syndromes

Volume

86

Issue

17 Supplement

First Page

B462

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