Health status outcomes in patients with acute myocardial infarction after rehospitalization

Supriya Shore*, K.G.E. Smolderen, Kevin F. Kennedy, Philip G. Jones, Suzanne V. Arnold, David J. Cohen, Joshua M. Stolker, Zhenxiang Zhao, Tracy Y. Wang, P. Michael Ho, John A. Spertus

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

6 Citations (Scopus)

Abstract

Background

Rehospitalizations after acute myocardial infarction for unplanned coronary revascularization and unstable angina (UA) are common. However, despite the inclusion of these events in composite end points of many clinical trials, their association with health status has not been studied.

Methods and Results

We included 3283 patients with acute myocardial infarction enrolled in a prospective, 24-center US study who had rehospitalizations independently classified by experienced cardiologists. Health status was assessed using Seattle Angina Questionnaire and EuroQol-5D Visual Analog Scale. In the propensity-matched cohorts, 1-year health status was compared between those who did and did not experience rehospitalization for UA or revascularization using a hierarchical linear model. Overall, mean age was 59 years, 33% were women, and 70% were white. Rehospitalization rates for UA and unplanned revascularization at 1 year were 4.3% and 4.7%. One-year Seattle Angina Questionnaire summary scores were worse in patients with rehospitalizations for UA (mean difference, -10.1; 95% confidence interval, -12.4 to -7.9) and unplanned revascularization (mean difference, -5.7; 95% confidence interval, -8.8 to -2.5) when compared with patients without such rehospitalizations. Similarly, EuroQol-5D Visual Analog Scale scores were worse among patients with such readmissions. Individual Seattle Angina Questionnaire domains indicated worse 1-year angina and quality of life outcomes among patients rehospitalized for UA or unplanned revascularization.

Conclusions

Within the first year after acute myocardial infarction, rehospitalizations for UA and unplanned revascularization are associated with worse health status. These findings highlight the impact of such events from a patient's perspective, beyond their economic impact and support the use of UA and unplanned revascularization as elements of composite end points.

Original languageEnglish
Pages (from-to)777-784
JournalCirculation. Cardiovascular Quality and Outcomes
Volume9
Issue number6
DOIs
Publication statusPublished - 2016

Keywords

  • health status
  • heart
  • myocardial infarction
  • quality of life
  • COMPOSITE END-POINTS
  • STROKE STATISTICS-2013 UPDATE
  • SEATTLE ANGINA QUESTIONNAIRE
  • AMERICAN-HEART-ASSOCIATION
  • ACUTE CORONARY SYNDROMES
  • QUALITY-OF-LIFE
  • CLINICAL-TRIALS
  • ARTERY-DISEASE
  • TASK-FORCE
  • MANAGEMENT

Cite this

Shore, S., Smolderen, K. G. E., Kennedy, K. F., Jones, P. G., Arnold, S. V., Cohen, D. J., Stolker, J. M., Zhao, Z., Wang, T. Y., Ho, P. M., & Spertus, J. A. (2016). Health status outcomes in patients with acute myocardial infarction after rehospitalization. Circulation. Cardiovascular Quality and Outcomes, 9(6), 777-784. https://doi.org/10.1161/CIRCOUTCOMES.116.002883