Results of an investigation published in the Nov. 28 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals, reveal that hospital readmission rates for individuals with a ST-segment elevation myocardial infarction (STEMI; a certain pattern on an electrocardiogram after a heart attack) who received a primary percutaneous coronary intervention (PCI) were 7% to 20% after three years for novel coronary revascularization procedures, heart attack, heart failure, and severe bleeding events, which were negatively connected with long-term survival for these individuals.

The researchers state:

“The implementation of primary percutaneous coronary intervention has significantly improved the clinical outcome of patients admitted for STEMI. However, some patients still develop recurrent adverse events, with a negative impact on survival.”

In order to analyze the three-year readmission rate for cardiovascular causes and their influence on death, Gianluca Campo, M.D., of the Azienda Ospedaliera Universitaria Sant’Anna and Laboratorio di Terapie e Tecnologie Avanzate, Ferrara, Italy, and colleagues examined data from the Regisiro Angioplastiche dell’Emilia-Romagna (REAL) registry. The population consisted of 11,118 individuals with STEMI (between January 2003 to June 2009) undergoing primary PCI who were enrolled in the REAL registry. After the initial hospitalization the team discovered 7,867 patients were readmitted.

The researchers explain:

“The most frequent diseases or conditions associated with hospital readmissions were coronary revascularization (CR; 28 percent), acute or congestive heart failure (HF; 26 percent), supraventricular arrhythmias (SA; 13 percent), MI (11 percent), and serious bleeding events (SBE; 10 percent). Interestingly, the patients with one hospital admission for HF, SA, or SBE frequently showed a second (or more) readmission for the same cause (36 percent, 34 percent, and 22 percent, respectively).

All these events tended to be more frequent during the first year. This was particularly evident for CR. Approximately 60 percent of these procedures was target vessel revascularization, whereas approximately 17 percent was staged intervention.”

They discovered that overall, there were 1,779 deaths with a cumulative incidence mortality rate of 12.1% at year-1 and 17.5% at year-3. Mortality was linked to patients requiring new hospitalization due to adverse events.

They write:

“Several registries suggest that there is an underuse of effective cardiac therapies. Our findings reinforce the need for the application of timely and effective preventive and treatment strategies.”

Written by Grace Rattue