Predictors of Readmission after the First Acute Coronary Syndrome and the Risk of Recurrent Cardiovascular Events—Seven Years of Patient Follow-Up
Cristiana Bustea,Delia Mirela Tit,Alexa Florina Bungau,Simona Bungau,Vlad Alin Pantea,E.E. Babes,Larisa Renata Pantea-Roșan +6 more
TL;DR: In this paper , the authors observed the outcomes of subjects after they suffered an acute coronary event and identified the factors that can predict rehospitalization in the first 12 months and the recurrence of another acute coronary episode.
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Abstract: 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, p < 0.001), acute pulmonary edema during the first hospitalization (6.47% vs. 1.24%, p = 0.022), coexistent valvular heart disease (69.15% vs. 55.90%, p = 0.017), and three-vessel disease (18.90% vs. 7.45%, p = 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%, p = 0.005). In multiple regression, complete revascularization during the index event (HR = 0.58, 95% CI 0.35–0.95, p = 0.03) and a higher LVEF (left ventricular ejection fraction) (HR = 0.95, 95% CI 0.92–0.988, p = 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.
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Lace Index: Predict the High‐Risk of 30‐Days Readmission of Patients With Acute Myocardial Infarction: National Health Insurance Claims Data 2011–2020
Vasuki Rajaguru,Whiejong Han,Suk-Yong Jang,Jae-Yong Shin,Sang Gyu Lee,Tae Hyun Kim,Vasuki Rajaguru,Whiejong Han,Suk-Yong Jang,Jae-Yong Shin,Sang Gyu Lee,Tae Hyun Kim +11 more
Abstract: ABSTRACT Background Readmission following acute myocardial infarction (AMI) poses significant challenges to health systems and patient outcomes. The LACE index, a composite of Length of stay, Acuity of admission, Comorbidities, and Emergency department visits, is widely used for readmission prediction. However, its performance in large‐scale, real‐world Korean cohorts remains understudied. Objective This study aimed to validate the predictive performance of the LACE index for 30‐day readmissions in AMI patients using a nationally representative Korean cohort. Methods This retrospective cohort study analyzed data from the Korean National Health Insurance Service Sample (NHISS) database from 2011 to 2020. A total of 609,640 adult patients hospitalized for AMI were included. The LACE index was calculated for each patient, and 30‐day readmissions were identified. Logistic regression was used to estimate odds ratios (ORs) for readmission. Model discrimination was assessed using ROC curve analysis and C‐statistics. Subgroup and survival analyses were performed by age, LACE score, and comorbidity burden. Results Among 609,640 AMI patients, 205 (0.034%) experienced 30‐day readmission. Patients with a LACE score of ≥ 10 had significantly higher odds of readmission (OR = 2.65; 95% CI: 1.68–4.19, p < 0.001) compared to those with scores 0–4. Middle‐aged adults (35–64 years) also showed elevated readmission risk (OR = 3.42; 95% CI: 1.74–6.73, p < 0.001), while older adults (≥ 65 years) did not have significantly different risk. The LACE index showed moderate discriminatory performance (C‐statistics = 0.71). Kaplan–Meier survival curves demonstrated significantly lower 30‐day survival among patients with LACE ≥ 10. Conclusions Study findings suggest the LACE index is a useful tool for predicting 30‐day readmissions among AMI patients in Korea. Its simplicity and moderate accuracy support its application in clinical and policy‐level risk stratification strategies. Future prospective studies should refine prediction models by incorporating additional clinical variables.
The Effect of Sleep Quality on Coronary Lesion Severity and Prognosis in the Young Acute Coronary Syndrome Population
Jia-xing Yang,Kexin Wang,Wenjie Wang,Jialong Niu,Xiaoli Liu,Yan Sun,Hailong Ge,Hongya Han +7 more
TL;DR: Long-term poor sleep quality was a risk factor for complex coronary lesions and has adverse effects on cardiovascular prognosis in the young ACS population.
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