Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Golden Jubilee National Hospital, UK.
Clin Cardiol. 2021 Mar;44(3):291-306. doi: 10.1002/clc.23543. Epub 2021 Feb 16.
Percutaneous coronary intervention (PCI) improves anginal chest pain in most, but not all, treated patients. PCI is associated with unplanned readmission for angina and non-specific chest pain within 30-days of index PCI. Patients with an index hospitalization for PCI between January-November in each of the years 2010-2014 were included from the United States Nationwide Readmissions Database. Of 2 723 455 included patients, the 30-day unplanned readmission rate was 7.2% (n = 196 581, 42.3% female). This included 9.8% (n = 19 183) with angina and 11.1% (n = 21 714) with non-specific chest pain. The unplanned readmission group were younger (62.2 vs 65.1 years; P < 0.001), more likely to be females (41.0% vs 34.2%; P < 0.001), from the lowest quartile of household income (32.9% vs 31.2%; P < 0.001), have higher prevalence of cardiovascular risk factors or have index PCI performed for non-acute coronary syndromes (ACS) (OR:3.46, 95%CI 3.39-3.54). Factors associated with angina readmissions included female sex (OR:1.28, 95%CI 1.25-1.32), history of ischemic heart disease (IHD) (OR:3.28, 95%CI 2.95-3.66), coronary artery bypass grafts (OR:1.79, 95%CI 1.72-2.86), anaemia (OR:1.16, 95%CI 1.11-1.21), hypertension (OR:1.13, 95%CI 1.09, 1.17), and dyslipidemia (OR:1.10, 95%CI 1.06-1.14). Non-specific chest pain compared with angina readmissions were younger (mean difference 1.25 years, 95% CI 0.99, 1.50), more likely to be females (RR:1.13, 95%CI 1.10, 1.15) and have undergone PCI for non-ACS (RR:2.17, 95%CI 2.13, 2.21). Indications for PCI other than ACS have a greater likelihood of readmission with angina or non-specific chest pain at 30-days. Readmissions are more common in patients with modifiable risk factors, previous history of IHD and anaemia.
经皮冠状动脉介入治疗（PCI）改善了大多数接受治疗的患者的心绞痛胸痛，但并非所有患者都能得到改善。在接受 PCI 指数治疗后的 30 天内，与计划外再入院相关的心绞痛和非特异性胸痛发生率为 30%。2010 年至 2014 年期间，美国全国再入院数据库中纳入了每年 1 月至 11 月接受 PCI 指数住院治疗的患者。在纳入的 2723455 例患者中，30 天非计划性再入院率为 7.2%（n=196581，42.3%为女性）。这包括 9.8%（n=19183）的心绞痛和 11.1%（n=21714）的非特异性胸痛。非计划性再入院组的年龄更小（62.2 岁 vs 65.1 岁；P <0.001），女性比例更高（41.0% vs 34.2%；P <0.001），来自家庭收入最低四分位数的患者更多（32.9% vs 31.2%；P <0.001），心血管危险因素的患病率更高，或因非急性冠脉综合征（ACS）而行 PCI 指数治疗（OR：3.46，95%CI 3.39-3.54）。与心绞痛再入院相关的因素包括女性（OR：1.28，95%CI 1.25-1.32）、缺血性心脏病（IHD）病史（OR：3.28，95%CI 2.95-3.66）、冠状动脉旁路移植术（OR：1.79，95%CI 1.72-2.86）、贫血（OR：1.16，95%CI 1.11-1.21）、高血压（OR：1.13，95%CI 1.09，1.17）和血脂异常（OR：1.10，95%CI 1.06-1.14）。与心绞痛再入院相比，非特异性胸痛患者年龄更小（平均差异 1.25 岁，95%CI 0.99，1.50），女性比例更高（RR：1.13，95%CI 1.10，1.15），且因非 ACS 而行 PCI（RR：2.17，95%CI 2.13，2.21）。除 ACS 以外的 PCI 指征更有可能在 30 天内出现心绞痛或非特异性胸痛再入院。有可改变的危险因素、既往 IHD 和贫血病史的患者再入院的可能性更大。
