Between 2005 and 2012, cardiac readmissions at one year post-AMI decreased from 20.8% to 14.9% (OR 0.94; 95% CI 0.92-0.96), though women remained at higher risk than men (OR 1.22; 95% CI 1.14-1.32).
Cohort (n=51,620)
Yes
Secondary prevention guideline adherence post-AMI improved over time, particularly for blood pressure, but significant gender disparities remain, with women experiencing worse risk factor control and higher readmission rates.
Effect estimate: OR 0.94 (95% CI 0.92-0.96)
Absolute Event Rate: 14.9% vs 20.8%
BACKGROUND: While secondary prevention improves prognosis after acute myocardial infarction (AMI), previous studies have suggested suboptimal guideline adherence, lack of improvement over time and gender differences. This study contributes contemporary data from a large national cohort. METHOD: We identified 51,620 patients <75 years examined at two and/or twelve months post AMI in the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART). Risk factor control and readmissions at one year were compared between the 2005 and 2012 cohorts, and between genders. RESULTS: Lipid control (LDL-cholesterol <2.5 mmol/L) improved from 67.9% to 71.1% (p = 0.016) over time, achieved by 67.9% vs 63.3%, p < 0.001 of men vs women. Blood pressure control (<140 mmHg systolic) increased over time (59.1% vs 69.5%, p < 0.001 in 2005 and 2012 cohorts) and was better in men (66.4% vs 61.9%, p < 0.001). Smoking cessation rate was 55.6% without differences between genders or over time. Cardiac readmissions occurred in 18.2% of women and 15.5% of men, decreasing from 2005 to 2012 (20.8% vs 14.9%). Adjusted odds ratio was 1.22 (95% CI 1.14-1.32) for women vs men and 0.94 (95% CI 0.92-0.96) for the 2012 vs the 2005 cohort. CONCLUSIONS: Although this study compares favourably to previous studies of risk factor control post AMI, improvement over time was mainly seen regarding blood pressure, revealing substantial remaining preventive potential. The reasons for gender differences seen in risk factor control and readmissions require further analysis.
Hambræus et al. (Mon,) conducted a cohort in acute myocardial infarction (n=51,620). 2012 cohort vs. 2005 cohort was evaluated on Cardiac readmissions at one year (OR 0.94, 95% CI 0.92-0.96). Between 2005 and 2012, cardiac readmissions at one year post-AMI decreased from 20.8% to 14.9% (OR 0.94; 95% CI 0.92-0.96), though women remained at higher risk than men (OR 1.22; 95% CI 1.14-1.32).