Author + information
- Martin Holzmann,
- Danijela Gasevic,
- Eric Rullman,
- Toralph Ruge,
- Axel Carlsson and
- Magnus Lundbäck
Background: Readmissions within 30 days after hospital stays have been introduced as a measure of quality of care. There is a paucity of data regarding sex-specific risk of early readmissions after myocardial infarction (MI).
Methods: We included all patients who sought medical attention for chest pain during 2011 and 2012 at our hospital, and who were diagnosed with MI. We used Swedish National Health care registers to retrieve information about patient characteristics, outcome data, and ongoing medication. We used logistic regression and calculated odds ratios (OR) with 95% confidence intervals (CI) for readmissions, coronary angiographies, revascularizations and cardiovascular medication in women vs. men.
Results: In total there were 667 patients with MI during the study period, of whom 197 (30%) were women. Women were older than men (mean age 73 vs. 65 years), more likely to have chronic kidney disease, diabetes, and heart failure. Moreover, women were less likely than men to be cared for in the cardiology department (68% vs. 85%). Throughout the first year during follow-up women were more likely to be readmitted than men, with the most striking difference found the first 30 days after discharge (adjusted OR 1.54 (95% CI, 1.00-2.36)). Only 21% of all readmissions within 30 days were because of MI, and 37% for any heart-related reason. Women were less likely to undergo coronary angiographies (56% vs. 75%) (crude OR 0.75 (95% CI, 0.60-0.93), and revascularizations (38% vs. 63%) (crude OR 0.61 (95% CI, 0.47-0.79)) than men during the index hospital stay. There were no differences in cardiovascular medication started during the index hospital stay except for statin therapy where 80% among women, compared to 93% among men had a filled prescription of statins within 90 days of discharge (crude OR 0.86 (95% CI 0.69-1.07)).
Conclusions: We found that women compared with men had a markedly increased risk of readmissions by 54% during the first 30 days after a hospital stay for MI. Women were less likely to undergo coronary angiographies, and revascularizations and to receive statin therapy during the index hospital stay than men which may partly explain our findings.
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: 1204-344
- 2017 American College of Cardiology Foundation