Tahir K, et al. - In this single center retrospective study, researchers investigated the mechanisms underlying ST-elevation myocardial infarction (STEMI) in 70 patients who had STEMI while hospitalized on a non-cardiac service and underwent coronary angiography. Findings revealed thrombotic etiologies in 39 (56%) patients and vasospasm, supply-demand mismatch, and Takotsubo cardiomyopathy were reported as non-thrombotic etiologies. More chances to have anti-platelet medications discontinued on admission, higher peak troponin levels and more likeliness to undergo percutaneous coronary intervention (PCI) were reported for patients in the thrombotic group vs patients in the non-thrombotic group. Thrombotic inpatient STEMI had longer ECG to coronary angiography times and 5-fold higher in-hospital mortality in comparison to 643 patients who presented with an out-of-hospital STEMI during the same time period. Overall, thrombotic and non-thrombotic mechanisms caused STEMI in hospitalized patients and were found to be related to a high mortality.