Systems of Care for ST-Segment-Elevation Myocardial Infarction: A Policy Statement From the American Heart Association

Circulation. 2021 Nov 16;144(20):e310-e327. doi: 10.1161/CIR.0000000000001025. Epub 2021 Oct 13.


The introduction of Mission: Lifeline significantly increased timely access to percutaneous coronary intervention for patients with ST-segment-elevation myocardial infarction (STEMI). In the years since, morbidity and mortality rates have declined, and research has led to significant developments that have broadened our concept of the STEMI system of care. However, significant barriers and opportunities remain. From community education to 9-1-1 activation and emergency medical services triage and from emergency department and interfacility transfer protocols to postacute care, each critical juncture presents unique challenges for the optimal care of patients with STEMI. This policy statement sets forth recommendations for how the ideal STEMI system of care should be designed and implemented to ensure that patients with STEMI receive the best evidence-based care at each stage in their illness.

Keywords: AHA Scientific Statements; ST-segment–elevation myocardial infarction; cardiac systems of care.

Publication types

  • Review

MeSH terms

  • American Heart Association
  • Clinical Decision-Making
  • Comprehensive Health Care
  • Delivery of Health Care* / legislation & jurisprudence
  • Delivery of Health Care* / methods
  • Delivery of Health Care* / standards
  • Delivery of Health Care* / statistics & numerical data
  • Disease Management
  • Health Education
  • Health Knowledge, Attitudes, Practice
  • Health Policy
  • Humans
  • Patient Transfer
  • Practice Guidelines as Topic
  • Primary Health Care
  • ST Elevation Myocardial Infarction / diagnosis*
  • ST Elevation Myocardial Infarction / etiology
  • ST Elevation Myocardial Infarction / therapy*
  • Secondary Care Centers
  • United States