Hospitalizations during the 30-day period preceding admissions with ST-elevation myocardial infarction: Insights from the Nationwide Readmission Database (NRD)

Chun Shing Kwok; Josip Andelo Borovac; Maximillian Will; Konstantin Schwarz; Jonathan Hinton; Eric Holroyd; Daniel F Hanley; Daniel E Ford; Gregory Y H Lip; Adnan I Qureshi

doi:10.1016/j.ijcard.2025.132991

Hospitalizations during the 30-day period preceding admissions with ST-elevation myocardial infarction: Insights from the Nationwide Readmission Database (NRD)

Int J Cardiol. 2025 Jan 16:423:132991. doi: 10.1016/j.ijcard.2025.132991. Online ahead of print.

Authors

Affiliations

¹ Department of Cardiology, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, UK. Electronic address: shingkwok@doctors.org.uk.
² Division of Interventional Cardiology, Cardiovascular Diseases Department, University Hospital of Split, Split, Croatia.
³ Karl Landsteiner University of Health Sciences, Krems, Austria; Division of Internal Medicine 3, University Hospital St. Pölten, St. Pölten, Austria; Karl Landsteiner Institute for Cardiometabolics, Karl Landsteiner Society, St. Pölten, Austria.
⁴ Karl Landsteiner University of Health Sciences, Krems, Austria; Division of Internal Medicine 3, University Hospital St. Pölten, St. Pölten, Austria.
⁵ Dorset Heart Centre, Royal Bournemouth Hospital, Bournemouth, UK.
⁶ Department of Cardiology, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, UK.
⁷ John Hopkins University, Baltimore, MD, USA.
⁸ Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, Liverpool Heart and Chest Hospital, Liverpool, UK; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
⁹ Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri Columbia Health Care, Columbia, MO, USA; Department of Neurology, University of Missouri, Columbia, MO, USA.

PMID: 39826577
DOI: 10.1016/j.ijcard.2025.132991

Abstract

Introduction: The extent and associated reasons or characteristics related to patients presenting to hospital prior with ST-elevation myocardial infarction (STEMI) are unknown.

Methods: This retrospective cohort study analyzed the Nationwide Readmission Database from 2018 to 2020 to evaluate hospitalizations within 30 days preceding a hospitalization with the diagnosis of STEMI in order to determine how often this occurs and what are the causes and factors associated with the recent admission.

Results: There were 1,355,765 hospital admissions with a diagnosis of STEMI and 54,545 (4.0 %) were hospitalized within 30-days prior to STEMI event. The most common causes of preceding hospitalization were sepsis, chronic ischemic heart disease, hypertensive disease with chronic kidney disease, complications of cardiac or vascular prosthetic devices, and implants/grafts, hypertensive heart disease with heart failure, and cerebral infarction. Independent factors associated with hospitalization within 30-days preceding STEMI, were cancer (OR 3.44 95 %CI 3.23-3.67, p < 0.001), elective admission (OR 2.76 95 %CI 2.59-2.95, p < 0.001), chronic kidney disease (OR 1.93 95 %CI 1.84-2.02, p < 0.001), chronic lung disease (OR 1.65 95 %CI 1.58-1.73, p < 0.001), previous stroke (OR 1.46 95 %CI 1.38-1.73, p < 0.001), and previous myocardial infarction (OR 1.45 95 %CI 1.37-1.53, p < 0.001).

Conclusions: Among the 4.0 % of patients were admitted to hospital within 30-days prior to a later admission for STEMI, predictors of such admissions were sepsis, chronic ischemic heart disease and hypertension and cancer. This raises potential opportunities to prevent future admissions with STEMI once such patients are hospitalized.

Keywords: Cancer; Chronic Ischemic Heart Disease; Hospitalization; Readmission; STEMI; Sepsis.