Hospitalizations during the 30-day period preceding the admission for the acute ST-elevation myocardial infarction: Insights from the Nationwide Readmission Database (NRD).

Introduction: The extent and associated reasons or characteristics related to patients presenting to hospital prior to acute 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 the current hospitalization for 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.