Key result
Unplanned 60-day readmission after PCI occurred in 6.0% of patients, was predicted by left main disease, and was associated with higher long-term all-cause mortality (8.5% vs 3.8%, P=0.05).
Why the study?
Does unplanned 60-day readmission after PCI predict long-term major adverse cardiovascular events and mortality?
Cohort (n=1,193)
No
Does unplanned 60-day readmission after PCI predict long-term major adverse cardiovascular events and mortality?
Unplanned 60-day readmission after PCI is primarily driven by the complexity of coronary artery disease (such as left main disease) and is associated with higher unadjusted long-term mortality.
Answers are grounded in this paper and cite their sources.
Post-PCI readmission signals unadjusted mortality risk; leaves open its independent prognostic value for long-term MACE or death.
AIMS: Thirty-day readmission rate after percutaneous coronary intervention (PCI) is used as an index of quality of care, but the complete recovery from any myocardial damage needs 8 weeks. We evaluated the readmission rate 60 days after PCI, defined its predictors, and investigated its relationship with long-term prognosis. METHODS AND RESULTS: All consecutive patients undergoing PCI in a large volume hospital were enrolled, and their outcomes were explored using an institutional database. The primary outcome was unplanned 60-day readmission. A composite of major adverse cardiovascular events (MACEs) including all-cause death, myocardial infarction, and repeated revascularization were the secondary endpoints. Among the 1193 enrolled patients, 71 (6.0%) underwent unplanned 60-day readmission for unstable angina (35.3%), chest pain (21.1%), heart failure (14.1%), and acute myocardial infarction (11.3%); 40.8% patients underwent repeated PCI. Readmitted patients carried more frequently left main disease (16.9 vs. 8.3%, P = 0.001), proximal left descending artery disease (31.0 vs. 27.4%, P = 0.03), and bifurcation disease (26.8 vs. 20.5%, P = 0.03). The only predictor of readmission was left main disease. After a mean follow-up of 743 ± 334 days, patients with 60-day readmission experienced higher rates of all-cause death (8.5 vs. 3.8%, P = 0.05). General baseline conditions and multivessel disease, but not 60-day readmissions, were predictors of MACE and death at follow-up. CONCLUSION: Unplanned 60-day readmissions after PCI are mainly related to the extent of coronary artery disease, being associated with left main, proximal left descending artery, and bifurcation disease. Readmissions are associated with higher long-term all-cause mortality.
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Moretti et al. (2015) conducted a cohort in Coronary artery disease requiring percutaneous coronary intervention (n=1,193). Percutaneous coronary intervention was evaluated on Unplanned 60-day readmission. Unplanned 60-day readmission after PCI occurred in 6.0% of patients, was predicted by left main disease, and was associated with higher long-term all-cause mortality (8.5% vs 3.8%, P=0.05).
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