Q & A with Dr. David Zielske
 

Question: NSTEMI for coronary intervention definition

I have a question in reference to Question ID 4429. There the question is posed "I have a question for you from the webcast on Tuesday regarding the Acute MI code. There is much confusion on whether or not a non-STEMI is an acute MI. Are we to assume that a non-STEMI is an Acute MI? If so, what clinical indications (documentation) would need to be present?" and your response was "We have asked the societies that created the code and left out their definition of MI. I know this is an issue with MD's. We will let you know when that definition is published." Could you tell me if this has been clarified? And if so, what is the definition? 

Answer

We have been told that an acute MI can be a STEMI or a NSTEMI.  Really look for the MD to state it is an acute NSTEMI or acute STEMI. There is no definite time limit at this point, however would expect this to be treated within the first 24 hours. Nevertheless, again, there is no definite time limit in the printed literature.  Examples of 90-minute door-to-balloon times are good examples, but do not exclude longer periods of time, either.