Predictors of Readmission after the First Acute Coronary Syndrome and the Risk of Recurrent Cardiovascular Events-Seven Years of Patient Follow-Up

• Published in: Life (Basel, Switzerland) Switzerland), 2023-04, Vol.13 (4), p.950
• Main Authors: Bustea, Cristiana, Tit, Delia Mirela, Bungau, Alexa Florina, Bungau, Simona Gabriela, Pantea, Vlad Alin, Babes, Elena Emilia, Pantea-Roșan, Larisa Renata
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Acute coronary syndromes; Angina pectoris; Archives & records; Blood clots; Cardiovascular diseases; Care and treatment; Clinical medicine; complete revascularization; Coronary heart disease; Coronary vessels; Development and progression; Diseases; Edema; Electrocardiography; first acute coronary syndrome; Health risks; Heart attacks; Heart diseases; Hospital care; hospital readmission; Hospitalization; Hospitals; Ischemia; Medical research; Medicine, Experimental; Patients; Population studies; predictors; Prognosis; recurrent cardiovascular events; Relapse; Risk factors; Statistics; STEMI; Ticagrelor; Ventricle
• ISSN: 2075-1729; 2075-1729
• DOI: 10.3390/life13040950

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, < 0.001), acute pulmonary edema during the first hospitalization (6.47% vs. 1.24%, = 0.022), coexistent valvular heart disease (69.15% vs. 55.90%, = 0.017), and three-vessel disease (18.90% vs. 7.45%, = 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%, = 0.005). In multiple regression, complete revascularization during the index event (HR = 0.58, 95% CI 0.35-0.95, = 0.03) and a higher LVEF (left ventricular ejection fraction) (HR = 0.95, 95% CI 0.92-0.988, = 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.