Aims: Risk factors and outcomes of in-hospital ST elevation myocardial infraction (STEMI) are well explored. Recent findings show that non-ST elevation myocardial infarction (NSTEMI) accounts for the majority of in-hospital infarctions (IHMIs). Our aim was to identify differences between IHMI and out-of-hospital myocardial infraction (OHMI) in terms of risk factors, treatment and outcomes, including both STEMI and NSTEMI. Methods: We analyzed the Regional Myocardial Infarction Registry of Saxony-Anhalt dataset. Patient characteristics, treatments and outcomes were compared between IHMI and OHMI. The association between clinical outcomes and myocardial infarction type was assessed using generalized additive models. Results: Overall, 11.4% of the included myocardial infractions were IHMI, and the majority were NSTEMI. Patients with IHMI were older and had more comorbidities than those with OHMI. Compared to OHMI, in-hospital myocardial infarction was associated with higher odds of 30-day mortality (OR = 1.85, 95% CI 1.32–2.59) and complications (OR = 2.36, 95 % CI 1.84–3.01). Conclusions: We provided insights on the full spectrum of IHMI, in both of its classifications. The proportion of IHMI was one ninth of all AMI cases treated in the hospital. Previously reported differences in the baseline characteristics and treatments, as well as worse clinical outcomes, in in-hospital STEMI compared to out-of-hospital STEMI persist even when including NSTEMI cases.

Purpose: The COVID-19 pandemic and containment measures disrupted daily life and worsened mental health. Stress, a key driver of mental disorders, likely intensified during this period. However, longitudinal studies tracking stress trajectories in the general population remain limited. This study aims to identify psychosocial stress trajectories from the pre- to post-pandemic period and examine associated characteristics in a population-based sample from a German city. Methods: 966 participants from the German National Cohort study-centre in Halle (240,000 inhabitants in Eastern Germany) were included. Those participated in a six-monthly intensified assessment and completed at least four questionnaires between 2019 and 2024 containing the PHQ-Stress module. First, latent class mixed models analysis identified heterogeneous stress trajectories. Second, associations between the most likely class membership and covariates were tested with multinomial and binomial logistic regressions. Results: We identified four psychosocial stress trajectory classes. Most participants followed a resilient trajectory (82%), while others showed chronic (4%), recovered (5%), or delayed (9%) trajectories. Membership in the resilient trajectory was associated with lower pre-pandemic psychological vulnerability, higher life satisfaction, greater agreeableness, and older age. Conclusion: Resilience predominated, while smaller subgroups showed less adaptive trajectories, with prior stress levels shaping long-term patterns. These findings demonstrate heterogeneity in stress responses and support the applicability of resilience frameworks such as Bonanno’s.

Purpose The COVID-19 pandemic and containment measures disrupted daily life and worsened mental health. Stress, a key driver of mental disorders, likely intensified during this period. However, longitudinal studies tracking stress trajectories in the general population remain limited. This study aims to identify psychosocial stress trajectories from the pre- to post-pandemic period and examine associated characteristics in a population-based sample from a German city. Methods 966 participants from the German National Cohort study-centre in Halle (240,000 inhabitants in Eastern Germany) were included. Those participated in a six-monthly intensified assessment and completed at least four questionnaires between 2019 and 2024 containing PHQ-Stress module. First, latent class growth analysis identified heterogeneous stress trajectories. Second, associations between class membership and covariates were tested with multinomial logistic regressions. Results We identified four psychosocial stress trajectory classes. Most participants followed an intermediate-level-stress trajectory (58%), while others showed low (30%), high (10%), or peak-recovery (3%) trajectories. Across classes, stress rose over time, with small to moderate changes, mostly early in the pandemic. Membership in the intermediate- or high-stress trajectories was associated with greater pre-pandemic stress, depressive and anxiety symptoms, lower life satisfaction, and greater loneliness at the pandemic’s onset. The peak-recovery class was associated with lower agreeableness and divorce before the pandemic, and reductions in sport activities at its onset. Conclusion Stable patterns of stress predominated, while a small subgroup showed stronger reactivity to pandemic-related strain. These findings suggest that, for most individuals, pre-existing vulnerability and stress levels shape long-term trajectories despite substantial contextual change.

Background/Objectives: In-hospital myocardial infarctions (AMIs) are less often treated with invasive intervention, compared to out-of-hospital AMIs. We aimed to identify the determinants of invasive intervention in patients with in-hospital AMIs and assess its association with mortality, compared to conservative treatment. Methods: This was a cross-sectional study of in-hospital AMIs in The Regional Myocardial Infarction Registry of Saxony-Anhalt. Patients’ characteristics and outcomes were compared based on the treatment strategy (invasive intervention vs. conservative treatment). Logistic regression was performed to assess the determinants of invasive intervention (vs. conservative treatment) and its association with 30-day mortality. Results: Nearly 67% of the patients (259/386) received invasive intervention, and the rest were treated conservatively. Those who were treated with an invasive intervention were younger and had a lower proportion of chronic heart failure than those treated conservatively. Age > 75 years compared to younger patients, pre-existing heart failure, and higher heart rate upon presentation were associated with lower odds of receiving invasive intervention. Hypertension (OR = 2.86, 95% CI [1.45–5.62]) and STEMI vs. NSTEMI (1.96, [1.10–3.68]) were associated with higher odds of invasive intervention. The adjusted odds of 30-day mortality were lower with invasive intervention compared to conservative treatment (0.25, [0.10–0.67]). Conclusions: One-third of the patients with in-hospital AMIs received conservative treatment. Younger age, absence of heart failure, lower heart rate, hypertension, and STEMI were determinants of invasive intervention usage. Invasive intervention had lower odds of 30-day mortality, but longitudinal studies are still needed to assess the efficacy of conservative vs. invasive strategies in in-hospital AMIs.