The thing to keep in mind about all these trends that I plot is that they are all dependent on clinical coding. Clinical coding is sort of twilight zone world where things are not quite as they seem.
For those not familiar with ACS think of it as an umbrella term for stuff arising from reduced blood flow to the heart muscle. If the muscle can’t get enough oxygen it stops functioning as it should. In extremis it will die and become necrotic (dead tissue).
ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina pectoris (UA) are all examples of ACS. When a physician scribbles STEMI in the casenotes this will get coded in the electronic patient record (EPR) as such but it may not get coded under the umbrella term ACS. If a clinical coder gets hold of the casenotes they will code this instance as STEMI and they might add an additional code for ACS. Sometimes STEMI gets coded as ACS. What really matters is what we do to the patient.
As a…