YuHsuan Shao, Alan C' Wilson, William J' Kostis, Nora M' Cosgrove, Abel E' Moreyra, John B' Kostis

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Yu-Hsuan Shao, Alan C. Wilson, William J.
Kostis, Nora M. Cosgrove, Abel E. Moreyra, John
B. Kostis For the MIDAS Study Group,
UMDNJ-Robert Wood Johnson Medical School, New
Brunswick, NJ
Recurrence of Acute Myocardial Infarction in a
Statewide Database
Background
Aim Methods
Results
In-Hospital Mortality Comparison
We used the Myocardial Infarction Data
Acquisition system (MIDAS), a database
including all patients discharged with the
diagnosis of AMI from non-federal hospitals in
New Jersey to examine the occurrence of a 2nd MI
(REMI) among 206,785 patients who were discharged
alive after an MI between 1986 to 2002.
There are many reports on the incidence and
mortality of acute myocardial infarction (MI).
However there is scant community-wide data
available on the occurrence of a second MI among
patients who were discharged alive after a first
MI.
REMI Patient Characteristics
REMI Rate Time to REMI
age comparing to 75 (lt65 OR 0.91 65-74 OR
0.86), plt0.05 male (OR 1.04), DM (OR 1.47),
(plt0.05). Hypertension (OR 1.20), (plt0.05).
hospital type (non teaching vs. teaching 1.10,
(plt0.05). Insurer comparing to HMO (OR blue
cross 1.06 commercial 1.07 Medicaid 1.35
Medicare 1.18 self-pay 1.18) discharge with a
NQMI (OR 1.15) are predictor of occurrence of 2nd
MI.
Conclusions
The rate of readmission for a second MI decreased
between 1986 and 2002 The rate remains high among
those discharged with NQMI Half of the 2nd MIs
occur within 60 days of discharge for the first
MI In-hospital and 1-year mortality is higher
than the first Both the occurrence and mortality
of the 2nd MI are determined by the same factors
related to long-term mortality of the first MI
(age, type of MI, co-morbidity and invasive
procedure use)