Author + information
- Ajar Kochar,
- Anita Chen,
- Puza Sharma,
- Neha Pagidipati,
- Gregg Fonarow,
- Eric Peterson and
- Tracy Wang
Background: While overall rates of cardiovascular disease are declining in the U.S., we have limited data on the incidence of recurrent myocardial infarction (MI) among patients treated for an acute MI in community practice.
Methods: CRUSADE was a national registry of acute coronary syndrome patients from 514 U.S. hospitals from 2001 to 2006. We linked MI patients ≥ age 65 discharged alive to Medicare data to identify downstream rates of readmission for MI over 5 years following discharge. A Cox proportional hazards model was performed to determine factors associated with MI readmission.
Results: Among 19,840 MI patients ≥ age 65, rates of aspirin (97%), beta-blocker (94%), and statin (86%) use at discharge was high. Despite this, the incidence of MI readmission was 12% at 1 year, 17% at 2 years and 26% at 5 years. Median time to first MI readmission was 14 months (25th, 75th percentiles: 3.5, 39). Among patients with recurrent MI, 34% had ≥2 recurrent MIs within 5 years of the index event. In the multivariable model, in-hospital revascularization was associated with a lower risk of MI readmission, whereas older age, diabetes, high Charlson comorbidity, and new heart failure during index admission were the strongest factors associated with risk of MI readmission within 5 years (Figure).
Conclusions: Recurrent MIs are common within 5 years after the index event and many patients had multiple recurrent MIs. These findings underscore the need for novel approaches to reduce the risk of recurrent MIs in this older population.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Cardiac Arrest, Diabetes, and Other High Risk Features of Patients With Acute Coronary Syndrome
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1204-337
- 2017 American College of Cardiology Foundation