Vu Hoang Tran MD, PhD , Darleen Lessard , Jay Parekh MD , Mayra S. Tisminetzky MPH, MD, PhD , Joel M. Gore MD , Jorge Yarzebski MD, MPH , Edgard Granillo MD , Tuyet T. Nguyen MD, PhD , Robert Goldberg PhD
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Nguyen MD, PhD , Robert Goldberg PhD","doi":"10.1016/j.cjco.2024.02.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Although ventricular tachycardia (VT) occurring during hospitalization for an acute myocardial infarction (AMI) increases mortality risk, its relationship with 30-day postdischarge rehospitalization has not been examined.</p></div><div><h3>Methods</h3><p>Using data from the Worcester Heart Attack Study, we examined the association between early (during the first 48 hours of admission) and late (after 48 hours from admission) VT with 30-day postdischarge all-cause and cardiovascular disease (CVD)-related rehospitalization while analytically controlling for several demographic and clinical factors.</p></div><div><h3>Results</h3><p>The study population consisted of 3534 patients who were hospitalized with an AMI between 2005 and 2015 (average age, 67.2 years; 40.7% women); VT occurred in 452 patients (13.7%), with the majority of instances (81.2%) occurring within 48 hours of admission. The 30-day all-cause rehospitalization rate was 17.3%, with 70.9% of the hospitalizations related to CVD. The odds of rehospitalization were 1.63 times (95% confidence interval [CI] = 0.99-2.69) and 1.12 times (95% CI = 0.83-1.51) higher for patients with AMI who developed late VT and early VT, respectively, compared to patients who did not develop VT. The risk of rehospitalization among patients with late VT was higher (odds ratio = 2.22 (95% CI = 0.79-6.26) in those with ST-segment-elevation AMI, compared to those with non-ST-segment-elevation AMI (odds ratio = 1.45 (95% CI = 0.81-2.57); early VT was not associated with rehospitalization in patients with either AMI subtype. No significant association was present between the occurrence of VT and CVD-related rehospitalization.</p></div><div><h3>Conclusions</h3><p>Patients who develop late VT may experience a higher risk of 30-day rehospitalization following hospital discharge for AMI, especially among those with ST-segment-elevation AMI. Larger studies are needed to confirm our findings.</p></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"6 6","pages":"Pages 781-789"},"PeriodicalIF":2.5000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589790X24000507/pdfft?md5=44b6e5bafc028cebf51b3bc546de57da&pid=1-s2.0-S2589790X24000507-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Ventricular Tachycardia and Hospital Readmission in Patients Discharged From the Hospital After an Acute Myocardial Infarction\",\"authors\":\"Vu Hoang Tran MD, PhD , Darleen Lessard , Jay Parekh MD , Mayra S. Tisminetzky MPH, MD, PhD , Joel M. Gore MD , Jorge Yarzebski MD, MPH , Edgard Granillo MD , Tuyet T. Nguyen MD, PhD , Robert Goldberg PhD\",\"doi\":\"10.1016/j.cjco.2024.02.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Although ventricular tachycardia (VT) occurring during hospitalization for an acute myocardial infarction (AMI) increases mortality risk, its relationship with 30-day postdischarge rehospitalization has not been examined.</p></div><div><h3>Methods</h3><p>Using data from the Worcester Heart Attack Study, we examined the association between early (during the first 48 hours of admission) and late (after 48 hours from admission) VT with 30-day postdischarge all-cause and cardiovascular disease (CVD)-related rehospitalization while analytically controlling for several demographic and clinical factors.</p></div><div><h3>Results</h3><p>The study population consisted of 3534 patients who were hospitalized with an AMI between 2005 and 2015 (average age, 67.2 years; 40.7% women); VT occurred in 452 patients (13.7%), with the majority of instances (81.2%) occurring within 48 hours of admission. The 30-day all-cause rehospitalization rate was 17.3%, with 70.9% of the hospitalizations related to CVD. The odds of rehospitalization were 1.63 times (95% confidence interval [CI] = 0.99-2.69) and 1.12 times (95% CI = 0.83-1.51) higher for patients with AMI who developed late VT and early VT, respectively, compared to patients who did not develop VT. The risk of rehospitalization among patients with late VT was higher (odds ratio = 2.22 (95% CI = 0.79-6.26) in those with ST-segment-elevation AMI, compared to those with non-ST-segment-elevation AMI (odds ratio = 1.45 (95% CI = 0.81-2.57); early VT was not associated with rehospitalization in patients with either AMI subtype. 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引用次数: 0
摘要
背景虽然急性心肌梗死(AMI)住院期间发生的室性心动过速(VT)会增加死亡风险,但其与出院后 30 天再住院的关系尚未得到研究。方法利用伍斯特心脏病发作研究的数据,我们研究了早期(入院后 48 小时内)和晚期(入院后 48 小时后)VT 与出院后 30 天全因和心血管疾病(CVD)相关再住院之间的关系,同时分析控制了几个人口统计学和临床因素。结果研究对象包括2005年至2015年期间因急性心肌梗死住院的3534名患者(平均年龄67.2岁;40.7%为女性);452名患者(13.7%)发生了VT,其中大部分(81.2%)发生在入院48小时内。30天全因再住院率为17.3%,其中70.9%的住院治疗与心血管疾病有关。与未发生VT的患者相比,发生晚期VT和早期VT的AMI患者再次住院的几率分别高出1.63倍(95% 置信区间 [CI] = 0.99-2.69)和1.12倍(95% CI = 0.83-1.51)。与非ST段抬高型AMI患者相比,ST段抬高型AMI晚期VT患者再次住院的风险更高(几率比为2.22(95% CI = 0.79-6.26))(几率比为1.45(95% CI = 0.81-2.57));两种AMI亚型患者中,早期VT都与再次住院无关。结论发生晚期VT的患者在AMI出院后30天内再次住院的风险可能较高,尤其是ST段抬高型AMI患者。需要更大规模的研究来证实我们的发现。
Ventricular Tachycardia and Hospital Readmission in Patients Discharged From the Hospital After an Acute Myocardial Infarction
Background
Although ventricular tachycardia (VT) occurring during hospitalization for an acute myocardial infarction (AMI) increases mortality risk, its relationship with 30-day postdischarge rehospitalization has not been examined.
Methods
Using data from the Worcester Heart Attack Study, we examined the association between early (during the first 48 hours of admission) and late (after 48 hours from admission) VT with 30-day postdischarge all-cause and cardiovascular disease (CVD)-related rehospitalization while analytically controlling for several demographic and clinical factors.
Results
The study population consisted of 3534 patients who were hospitalized with an AMI between 2005 and 2015 (average age, 67.2 years; 40.7% women); VT occurred in 452 patients (13.7%), with the majority of instances (81.2%) occurring within 48 hours of admission. The 30-day all-cause rehospitalization rate was 17.3%, with 70.9% of the hospitalizations related to CVD. The odds of rehospitalization were 1.63 times (95% confidence interval [CI] = 0.99-2.69) and 1.12 times (95% CI = 0.83-1.51) higher for patients with AMI who developed late VT and early VT, respectively, compared to patients who did not develop VT. The risk of rehospitalization among patients with late VT was higher (odds ratio = 2.22 (95% CI = 0.79-6.26) in those with ST-segment-elevation AMI, compared to those with non-ST-segment-elevation AMI (odds ratio = 1.45 (95% CI = 0.81-2.57); early VT was not associated with rehospitalization in patients with either AMI subtype. No significant association was present between the occurrence of VT and CVD-related rehospitalization.
Conclusions
Patients who develop late VT may experience a higher risk of 30-day rehospitalization following hospital discharge for AMI, especially among those with ST-segment-elevation AMI. Larger studies are needed to confirm our findings.