Characteristics and Outcomes of Early Recurrent Myocardial Infarction After Acute Myocardial Infarction.

Content Provider	Europe PMC
Author	Nair, Raunak Johnson, Michael Kravitz, Kathleen Huded, Chetan Rajeswaran, Jeevanantham Anabila, Moses Blackstone, Eugene Menon, Venu Lincoff, A. Michael Kapadia, Samir Khot, Umesh N.
Abstract	BackgroundWe aimed to understand the characteristics and outcomes of patients readmitted with a recurrent myocardial infarction (RMI) within 90 days of discharge after an acute myocardial infarction (early RMI).Methods and ResultsWe analyzed the timing of reinfarction, etiology, and outcome for all patients admitted with an early RMI within 90 days of discharge after an acute myocardial infarction between January 1, 2010 and January 1, 2017. We identified 6626 admissions for acute myocardial infarction (index myocardial infarction) which led to 168 cases of RMI within 90 days of discharge. The mean patient age was 65.1±13.1 years, and 37% were women. The 90‐day probability of readmission with an early RMI was 2.5%. Black race, medical management, higher troponin T, and shorter length of stay were independent predictors of early RMI. Medically managed group had a higher risk for early RMI compared with percutaneous coronary intervention (P=0.04) or coronary artery bypass grafting (P=0.2). Predominant mechanisms for reinfarction were stent thrombosis (17%), disease progression (12%), and unchanged coronary artery disease (11%). At 5 years, the all‐cause mortality rate for patients with an early RMI was 49% (95% CI, 40%–57%) compared with 22% (95% CI, 21%–23%) for patients without an early RMI (P<0.0001).ConclusionsEarly RMI is a life‐threatening condition with nearly 50% mortality within 5 years. Stent‐related events and progression in coronary artery disease account for most early RMI. Medication compliance, aggressive risk factor management, and care transitions should be the cornerstone in preventing early RMI.
Page Count	11
Journal	Journal of the American Heart Association
Volume Number	10
PubMed Central reference number	PMC8475017
Issue Number	16
PubMed reference number	34333986
e-ISSN	20479980
DOI	10.1161/jaha.120.019270
Language	English
Publisher	John Wiley and Sons Inc.
Publisher Date	2021-08-02
Publisher Place	Hoboken
Access Restriction	Open
Rights License	This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Subject Keyword	coronary artery disease early recurrent myocardial infarction readmission reinfarction stent thrombosis Myocardial Infarction
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine