Key result
Complete revascularization at index acute coronary event linked to ~42% lower 1-year readmissions.
Why the study?
Recurrent hospitalization after ACS is common, making identification of risk factors associated with subsequent cardiovascular events and hospitalization essential for patient management.
Does complete revascularization reduce the risk of early readmission in patients with a first acute coronary syndrome?
Cohort (n=362)
No
Does complete revascularization reduce the risk of early readmission in patients with a first acute coronary syndrome?
Hazard Ratio: 0.58 (95% CI 0.35–0.95)
Absolute Event Rate: 24.87% vs 34.78%
p-value: p=0.03
Complete revascularization and preserved LVEF during a first ACS event are critical independent predictors of reduced hospital readmission risk within the first year.
May reduce readmissions after first ACS; hypothesis-generating and requires randomized confirmation.
Recurrent hospitalization after acute coronary syndromes (ACS) is common. Identifying risk factors associated with subsequent cardiovascular events and hospitalization is essential for the management of these patients. Our research consisted in observing the outcomes of subjects after they suffered an acute coronary event and identifying the factors that can predict rehospitalization in the first 12 months and the recurrence of another acute coronary episode. Data from 362 patients admitted with ACS during 2013 were studied. Recurrent hospitalizations were retrospectively reviewed from medical charts and electronic hospital archives over a period of seven years. The mean age of the studied population was 64.57 ± 11.79 years, 64.36% of them being males. The diagnosis of ACS without ST elevation was registered in 53.87% of the patients at index hospitalization. More than half had recurrent hospitalization in the first year after the first ACS episode. Patients with lower ejection fraction (39.20 ± 6.85 vs. 42.24 ± 6.26, p < 0.001), acute pulmonary edema during the first hospitalization (6.47% vs. 1.24%, p = 0.022), coexistent valvular heart disease (69.15% vs. 55.90%, p = 0.017), and three-vessel disease (18.90% vs. 7.45%, p = 0.002) were more frequently readmitted in the following twelve months after their first acute coronary event, while those with complete revascularization were less frequently admitted (24.87% vs. 34.78%, p = 0.005). In multiple regression, complete revascularization during the index event (HR = 0.58, 95% CI 0.35–0.95, p = 0.03) and a higher LVEF (left ventricular ejection fraction) (HR = 0.95, 95% CI 0.92–0.988, p = 0.009) remained independent predictors of fewer early readmissions. Complete revascularization of the coronary lesions at the time of the first event and a preserved LVEF were found to be the predictors of reduced hospitalizations in the first year after an acute coronary event.
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Bustea et al. (2023) conducted a cohort in First Acute Coronary Syndrome (ACS) (n=362). Complete revascularization vs. Incomplete revascularization was evaluated on Readmission in the first 12 months after the index acute coronary event (HR 0.58, 95% CI 0.35-0.95, p=0.03). Complete revascularization at the time of the first acute coronary event significantly reduced early readmissions in the following 12 months (HR 0.58, 95% CI 0.35-0.95, p=0.03).
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