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Article
Characteristics of Contemporary Patients Discharged From the Hospital After an Acute Coronary Syndrome
UMass Center for Clinical and Translational Science Supported Publications
  • Robert J. Goldberg, University of Massachusetts Medical School
  • Jane S. Saczynski, University of Massachusetts Medical School
  • David D. McManus, University of Massachusetts Medical School
  • Molly E. Waring, University of Massachusetts Medical School
  • Richard H. McManus, University of Massachusetts Medical School
  • Jeroan J. Allison, University of Massachusetts Medical School
  • David C. Parish, Mercer University
  • Darleen M. Lessard, University of Massachusetts Medical School
  • Sharina D. Person, University of Massachusetts Medical School
  • Joel Gore, University of Massachusetts Medical School
  • Catarina I. Kiefe, University of Massachusetts Medical School
UMMS Affiliation
Department of Quantitative Health Sciences; Department of Medicine, Division of Cardiovascular Medicine; Meyers Primary Care Institute; Department of Medicine, Division of Geriatric Medicine
Date
5-23-2015
Document Type
Article
Abstract

BACKGROUND: Limited contemporary data compare the clinical and psychosocial characteristics and acute management of patients hospitalized with an initial vs a recurrent episode of acute coronary disease. We describe these factors in a cohort of patients recruited from 6 hospitals in Massachusetts and Georgia after an acute coronary syndrome.

MATERIALS AND METHODS: We performed structured baseline in-person interviews and medical record abstractions for 2174 eligible and consenting patients surviving hospitalization for an acute coronary syndrome between April 2011 and May 2013.

RESULTS: The average patient age was 61 years, 64% were men, and 47% had a high school education or less; 29% had a low general quality of life, and 1 in 5 were cognitively impaired. Patients with a recurrent coronary episode had a greater burden of previously diagnosed comorbidities. Overall, psychosocial burden was high, and more so in those with a recurrent vs those with an initial episode. Patients with an initial coronary episode were as likely to have been treated with all 4 effective cardiac medications (51.6%) as patients with a recurrent episode (52.3%), but were significantly more likely to have undergone cardiac catheterization (97.9% vs 92.9%) and a percutaneous coronary intervention (73.7% vs 60.9%) (P < .001) during their index hospitalization.

CONCLUSIONS: Patients with a first episode of acute coronary artery disease have a more favorable psychosocial profile, less comorbidity, and receive more invasive procedures but similar medical management, than patients with previously diagnosed coronary disease. Implications of the high psychosocial burden on various patient-related outcomes require investigation.

Rights and Permissions
Citation: Am J Med. 2015 May 23. pii: S0002-9343(15)00429-5. doi: 10.1016/j.amjmed.2015.05.002. Link to article on publisher's site
Related Resources
Link to Article in PubMed
Keywords
  • UMCCTS funding
PubMed ID
26007672
Citation Information
Robert J. Goldberg, Jane S. Saczynski, David D. McManus, Molly E. Waring, et al.. "Characteristics of Contemporary Patients Discharged From the Hospital After an Acute Coronary Syndrome" (2015) ISSN: 0002-9343 (Linking)
Available at: http://works.bepress.com/catarina_kiefe/234/