Abstract 283: Health Status Outcomes in Acute Myocardial Infarction Patients Following Rehospitalization for Unplanned Revascularization or Unstable Angina
Background: Rehospitalizations for unplanned coronary revascularization and unstable angina (UA) among patients after myocardial infarction (MI) are common. The association of these events with health status is unknown.
Methods: Patients with MI were enrolled between 2005 and 2008 in the TRIUMPH registry-a prospective, 24 center U.S. study. Follow-up was attempted on all survivors at 1, 6 and 12 months after index MI admission. Data on all reported re-hospitalizations were adjudicated. Staged revascularizations and elective coronary artery bypass grafts performed within the first month after the index MI were excluded. Health status was assessed using the Seattle Angina Questionnaire (SAQ) and Euroqol-5D Visual Analog Scale (EQ-5D VAS). One-year health status was compared between those who did and did not experience a rehospitalization due to a coronary revascularization or UA using hierarchical, repeated measures analyses in 2 propensity-matched cohorts created for each of these events.
Results: A total of 3,283 MI patients were analyzed; mean age was 59 years, 33% were female and 70% were Caucasian. In the year following the MI there were 144 (4.4%) re-hospitalizations for unplanned coronary revascularization and 140 (4.3%) for UA. Baseline health status was comparable between patients with and without re-hospitalizations. In contrast, SAQ summary scores at 1 year post-MI were lower in patients with re-hospitalizations for unplanned revascularization (-10.1; 95% CI -12.4, -7.9) and UA readmissions (mean difference -6.9; 95% CI -9.1, -4.7) vs. those without. Similarly, EQ-5D VAS scores were lower among patients with readmissions for unplanned revascularization and UA readmissions (Table). Individual domains of the SAQ score indicated higher angina frequency, worse quality of life, and more physical limitations over the year following the index MI among patients re-hospitalized for UA and revascularization.
Conclusions: Rehospitalizations within the first year following a MI for unplanned coronary revascularization and UA are associated with more angina and worse health status. Whether more aggressive treatment of patients’ health status can prevent these events, or if preventing these events can improve patients’ health status, requires further study.
Author Disclosures: S. Shore: None. Y. Li: None. K. Smolderen: None. P.G. Jones: None. S.V. Arnold: None. D. Cohen: None. J. Zhenxiang: A. Employment; Significant; Global Health Outcomes, Eli Lily and Company, Indianapolis, IN. T.Y. Wang: None. P. Ho: None. J. Spertus: None.
- © 2014 by American Heart Association, Inc.