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Freites A, Hernando L, Salinas P, Cánovas E, de la Rosa A, Alonso J, Del Castillo R, Núñez A, Botas J. Incidence and prognosis of late readmission after percutaneous coronary intervention. Cardiol J 2022; 30:696-704. [PMID: 36510791 PMCID: PMC10635725 DOI: 10.5603/cj.a2022.0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 10/22/2022] [Accepted: 11/05/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Early readmission (< 30 days) after percutaneous coronary intervention (PCI) is associated with a worse prognosis, but little is known regarding the causes and consequences of late readmission. The aim of the present study was to determine the incidence, causes, and prognosis of patients readmitted > 1 < 12-months after PCI (late readmission). METHODS Single-center retrospective cohort study of 743 consecutive post-PCI patients. Patient characteristics and follow-up data were collected by reviewing their electronic medical records and from standardized telephone interviews performed at 1 year and at the end of follow-up. RESULTS Of the 743 patients, 224 (30.14%) were readmitted 1-12 months after PCI, 109 due to chest pain (48.66%), and 115 for other reasons (51.34%). Hospital readmission was associated with lower survival rates of 77.6% vs. 98.3% at 24 months and 73.5% vs. 97.6% at 36 months (p < 0.001). Univariate predictors for late readmission were hypertension, older age, chronic kidney disease, lower left ventricular ejection fraction, and lower baseline hemoglobin concentration. Only baseline hemoglobin concentration was an independent predictor of late readmission (odds ratio: 0.867, 95% confidence interval: 0.778-0.966, p = 0.01). Readmission for chest pain portrayed a lower mortality rate compared to other causes, with survival rates of 90.2% vs. 50% at 36 months (p < 0.001). CONCLUSIONS Late hospital readmission after PCI is associated with a worse prognosis and is related to patient comorbidities. Readmission for chest pain is common and portrayed a more favorable prognosis, similar to patients not readmitted. A readily available parameter, baseline anemia, was the main predictor of late readmission.
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Affiliation(s)
- Alfonso Freites
- Cardiology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Lorenzo Hernando
- Cardiology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Pablo Salinas
- Cardiology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Ester Cánovas
- Cardiology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Adriana de la Rosa
- Cardiology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Javier Alonso
- Cardiology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Alberto Núñez
- Cardiology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Javier Botas
- Cardiology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
- Rey Juan Carlos University School of Medicine, Madrid, Spain.
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Rodríguez-Leor O, Cid-Álvarez B, Pérez de Prado A, Rossello X, Ojeda S, Serrador A, López-Palop R, Martín-Moreiras J, Rumoroso JR, Cequier Á, Ibáñez B, Cruz-González I, Romaguera R, Moreno R, Villa M, Ruíz-Salmerón R, Molano F, Sánchez C, Muñoz-García E, Íñigo L, Herrador J, Gómez-Menchero A, Gómez-Menchero A, Caballero J, Ojeda S, Cárdenas M, Gheorghe L, Oneto J, Morales F, Valencia F, Ruíz JR, Diarte JA, Avanzas P, Rondán J, Peral V, Pernasetti LV, Hernández J, Bosa F, Lorenzo PLM, Jiménez F, Hernández JMDLT, Jiménez-Mazuecos J, Lozano F, Moreu J, Novo E, Robles J, Moreiras JM, Fernández-Vázquez F, Amat-Santos IJ, Gómez-Hospital JA, García-Picart J, Blanco BGD, Regueiro A, Carrillo-Suárez X, Tizón H, Mohandes M, Casanova J, Agudelo-Montañez V, Muñoz JF, Franco J, Del Castillo R, Salinas P, Elizaga J, Sarnago F, Jiménez-Valero S, Rivero F, Oteo JF, Alegría-Barrero E, Sánchez-Recalde Á, Ruíz V, Pinar E, Pinar E, Planas A, Ledesma BL, Berenguer A, Fernández-Cisnal A, Aguar P, Pomar F, Jerez M, Torres F, García R, Frutos A, Nodar JMR, García K, Sáez R, Torres A, Tellería M, Sadaba M, Mínguez JRL, Merchán JCR, Portales J, Trillo R, Aldama G, Fernández S, Santás M, Pérez MPP. Impact of COVID-19 on ST-segment elevation myocardial infarction care. The Spanish experience. ACTA ACUST UNITED AC 2020; 73:994-1002. [PMID: 32917566 PMCID: PMC7834732 DOI: 10.1016/j.rec.2020.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/28/2020] [Indexed: 12/29/2022]
Abstract
Introduction and objectives The COVID-19 outbreak has had an unclear impact on the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess changes in STEMI management during the COVID-19 outbreak. Methods Using a multicenter, nationwide, retrospective, observational registry of consecutive patients who were managed in 75 specific STEMI care centers in Spain, we compared patient and procedural characteristics and in-hospital outcomes in 2 different cohorts with 30-day follow-up according to whether the patients had been treated before or after COVID-19. Results Suspected STEMI patients treated in STEMI networks decreased by 27.6% and patients with confirmed STEMI fell from 1305 to 1009 (22.7%). There were no differences in reperfusion strategy (> 94% treated with primary percutaneous coronary intervention in both cohorts). Patients treated with primary percutaneous coronary intervention during the COVID-19 outbreak had a longer ischemic time (233 [150-375] vs 200 [140-332] minutes, P < .001) but showed no differences in the time from first medical contact to reperfusion. In-hospital mortality was higher during COVID-19 (7.5% vs 5.1%; unadjusted OR, 1.50; 95%CI, 1.07-2.11; P < .001); this association remained after adjustment for confounders (risk-adjusted OR, 1.88; 95%CI, 1.12-3.14; P = .017). In the 2020 cohort, there was a 6.3% incidence of confirmed SARS-CoV-2 infection during hospitalization. Conclusions The number of STEMI patients treated during the current COVID-19 outbreak fell vs the previous year and there was an increase in the median time from symptom onset to reperfusion and a significant 2-fold increase in the rate of in-hospital mortality. No changes in reperfusion strategy were detected, with primary percutaneous coronary intervention performed for the vast majority of patients. The co-existence of STEMI and SARS-CoV-2 infection was relatively infrequent.
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Affiliation(s)
- Oriol Rodríguez-Leor
- Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Institut de Recerca en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain.
| | - Belén Cid-Álvarez
- Servicio de Cardiología, Hospital Clínico de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | | | - Xavier Rossello
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Servicio de Cardiología, Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma de Mallorca, Islas Baleares, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Soledad Ojeda
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain
| | - Ana Serrador
- Servicio de Cardiología, Hospital Clínico de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Ramón López-Palop
- Servicio de Cardiología, Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Javier Martín-Moreiras
- Servicio de Cardiología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - José Ramón Rumoroso
- Servicio de Cardiología, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, Spain
| | - Ángel Cequier
- Servicio de Cardiología, Hospital de Bellvitge-Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Borja Ibáñez
- Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Servicio de Cardiología, Hospital Universitario IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Ignacio Cruz-González
- Servicio de Cardiología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Romaguera
- Servicio de Cardiología, Hospital de Bellvitge-Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Raúl Moreno
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jesús Oneto
- Hospital Universitario de Jerez de la Frontera
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Juan Franco
- Hospital Universitario Fundación Jiménez Díaz
| | | | - Pablo Salinas
- Hospital Clínico San Carlos y Hospital Príncipe de Asturias
| | | | | | | | | | | | | | | | | | | | - Eduardo Pinar
- Luciano Consuegra-Sánchez, Hospital Universitario Santa Lucía de Cartagena
| | - Ana Planas
- Hospital General Universitario de Castellón
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ramiro Trillo
- Hospital Clínico Universitario Santiago de Compostela
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