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Clinical and angiographic outcomes of patients treated with everolimus-eluting stents or first-generation Paclitaxel-eluting stents for unprotected left main disease Management of Asymptomatic Severe Aortic Stenosis: Evolving Concepts in Timing of Valve Replacement Transcatheter Aortic Valve Replacement in Patients With Multivalvular Heart Disease Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality Cardiac surgery following transcatheter aortic valve replacement Determinants and Impact of Heart Failure Readmission Following Transcatheter Aortic Valve Replacement Long-Term All-Cause and Cause-Specific Mortality in Asymptomatic Patients With CAC ≥1,000: Results From the CAC Consortium The sinus venosus contributes to coronary vasculature through VEGFC-stimulated angiogenesis Intravascular ultrasound-guided unprotected left main coronary artery stenting in the elderly 2019 AHA/ACC Clinical Performance and Quality Measures for Adults With High Blood Pressure: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures

Original Research2019 Apr 22;12(8):734-748.

JOURNAL:JACC Cardiovasc Interv. Article Link

Timing and Causes of Unplanned Readmissions After Percutaneous Coronary Intervention: Insights From the Nationwide Readmission Database

Kwok CS, Shah B, Mamas M et al. Keywords: cost; PCI; readmissions

ABSTRACT


OBJECTIVES - The aim of this study was to describe the rates and causes of unplanned readmissions at different time periods following percutaneous coronary intervention (PCI).


BACKGROUND - The rates and causes of readmission at different time periods after PCI remain incompletely elucidated.


METHODS - Patients undergoing PCI between 2010 and 2014 in the U.S. Nationwide Readmission Database were evaluated for the rates, causes, predictors, and costs of unplanned readmission between 0 and 7 days, 8 and 30 days, 31 and 90 days, and 91 and 180 days after index discharge.


RESULTS - This analysis included 2,412,000 patients; 2.5% were readmitted between 0 and 7 days, 7.6% between 8 and 30 days, 8.9% between 31 and 90 days, and 8.0% between 91 and 180 days (cumulative rates 2.5%, 9.9%, 18.0%, and 24.8%, respectively). The majority of readmissions during each time period were due to noncardiac causes (53.1% to 59.6%). Nonspecific chest pain was the most common identifiable noncardiac cause for readmission during each time period (14.2% to 22.7% of noncardiac readmissions). Coronary artery disease including angina was the most common cardiac cause for readmission during each time period (37.4% to 39.3% of cardiac readmissions). The second most common cardiac cause for readmission was acute myocardial infarction between 0 and 7 days (27.6% of cardiac readmissions) and heart failure during all subsequent time periods (22.2% to 23.7% of cardiac readmissions).


CONCLUSIONS - Approximately 25% of patients following PCI have unplanned readmissions within 6 months. Causes of readmission depend on the timing at which they are assessed, with noncardiovascular causes becoming more important at longer time points.

Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.