“Perhaps they are pursuing less-aggressive care or they have advanced directives in place, and so that may prevent them from showing up for care,” said Dr. Ward.

With fewer patients presenting to the ED with STEMI, physicians—especially emergency physicians and those in training—need to stay up-to-date on diagnosis and treatment, Dr. Ward advised, particularly since time-to-treatment standards will continue to persist and EDs may be more likely to see atypical, less-clear-cut STEMI patients.

He suggested physicians continue to review characteristic ECGs and other modalities to stay current.

“I think it’s a good thing for patients, but the potential unintended consequence is that providers and facilities themselves are not as experienced with caring for that population,” he said.

In the United States, the estimated costs of acute heart disease care is $67.4 billion for hospital inpatient stays and $5.6 billion for ED visits, the study cited. This is seven times higher than the $10 billion annually it costs for preventive medication, Dr. Ward said.

“At what point do we start to say that we need to shift even more money on prevention?” Dr. Ward asked, noting the current study does not attempt to address this.