Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/1476
Title: Trends and predictors of recurrent acute coronary syndrome hospitalizations and unplanned revascularization after index acute myocardial infarction treated with coronary intervention.
Author: Yudi, M.
Clark, D.
Farouque, O.
Andrianopoulos, N.
Ajani, A.
Brennan, A.
Leftkovits, J.
Freeman, M.
Hiew, C.
Selkrig, L.
O'Brien, J.
Dart, A.
Reid, C.
Duffy, S.
Institutional Author: Melbourne Interventional Group
Issue Date: 2020
Publication Title: American Heart Journal
Volume: 212
Start Page: 134
End Page: 143
Abstract: Background Repeat hospitalizations for recurrent acute coronary syndrome (ACS) or unplanned revascularization after acute myocardial infarction (MI) are common, costly and potentially preventable. We aim to describe 10-year trends and identify independent risk factors of these repeat hospitalizations. Methods We analyzed data from 9615 patients from the Melbourne Interventional Group registry (2005–2014) who underwent percutaneous coronary intervention (PCI) for their index MI and survived to discharge. Patients with ≥1 hospitalization for recurrent ACS events and/or unplanned revascularization in the year after discharge were included in the recurrent coronary hospitalization group. We assessed yearly trends of recurrent coronary events and identified independent predictors using multivariate analysis. Results Recurrent coronary hospitalization occurred in 1175 (12.2%) patients. There was a significant decrease in the rate of recurrent ACS hospitalization (15.3%-7.6%, P for trend <.001) and unplanned revascularization (4.2%-2.1%, P for trend = .01), but not in all-cause re-hospitalizations (P for trend = .28). On multivariate analysis, female gender, diabetes mellitus, previous coronary bypass surgery, previous PCI, reduced ejection fraction, heart failure, multi-vessel coronary disease and obstructive sleep apnea were independent predictors of recurrent coronary hospitalizations (all P < .05). Conclusions Recurrent hospitalization for ACS or unplanned revascularization has decreased significantly over the past decade. Risk factors for such events are numerous and largely non-modifiable, however they identify a cohort of patients in whom non-culprit vessel PCI in multi-vessel disease, optimization of left ventricular dysfunction and diabetes management may improve outcomes.
Description: Includes BHS data.
URI: http://hdl.handle.net/11054/1476
Resource Link: https://doi.org/10.1016/j.ahj.2019.02.013
Internal ID Number: 01455
Health Subject: ACUTE CORONARY SYNDROME
UNPLANNED REVASCULARIZATION
ACUTE MYOCARDIAL INFARCTION
INDEPENDENT RISK FACTORS
Type: Journal Article
Article
Appears in Collections:Research Output

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.