Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/20710
Title: Trends and predictors of recurrent acute coronary syndrome hospitalizations and unplanned revascularization after index acute myocardial infarction treated with percutaneous coronary intervention.
Authors: Yudi, Matias B;Clark, David J;Farouque, Omar;Andrianopoulos, Nick;Ajani, Andrew E;Brennan, Angela;Lefkovits, Jeffrey;Freeman, Melanie;Hiew, Chin;Selkrig, Laura A;O'Brien, Jessica;Dart, Anthony M;Reid, Christopher M;Duffy, Stephen J
Affiliation: School of Public Health, Curtin University, Perth, Australia
Department of Medicine, University of Melbourne, Melbourne, Australia
Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia
Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia
Department of Cardiology, Geelong Hospital, Geelong, Australia
Department of Cardiology, Box Hill Hospital, Melbourne, Australia
Centre of Cardiovascular Research and Education in Therapeutics (CCRE), Monash University, Melbourne, Australia
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 5-Mar-2019
EDate: 2019
Citation: American heart journal 2019; 212: 134-143
Abstract: 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. 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. 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). 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.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20710
DOI: 10.1016/j.ahj.2019.02.013
ORCID: 0000-0002-3706-4150
PubMed URL: 31004916
Type: Journal Article
Appears in Collections:Journal articles

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