P2726Characteristics, trends and outcomes associated with 30-day readmissions following acute coronary syndrome 2000-2013: the acute coronary syndrome israeli survey (ACSIS)

Background: Readmissions following acute myocardial infarction are associated with poor outcome and a heavy economic burden. There are few evidence-based data on the characteristics and outcome of patients readmitted following acute coronary syndrome (ACS). Purpose: To explore national trends, indices and prognosis associated with readmission at 30 days post-ACS over the past decade. Methods: The study population comprised all ACS patients who were enrolled and prospectively followed-up in the biennial Acute Coronary Syndrome Israeli Survey (ACSIS) from 2000 through 2013. Multivariate analysis identified factors independently associated with readmission and long-term mortality. Results: There were 13,010 study patients, of whom 556 (4.2%) were readmitted urgently within 30 days of the index event. Stent thrombosis during the index hospitalization (OR 8.43 [4.11–16.07]; p<0.001), female sex (OR=1.34 [1.1–1.63]; p=0.003), older age (>65 years; OR=1.28; [1.06–1.55]; p=0.011), and lack of dual-antiplatelet therapy (OR=1.52 [1.25–1.86]; p<0.001) were independently associated with readmission. Readmitted patients were less likely to have been treated with guideline-directed medical therapy during hospitalization and at discharge, and were less likely to have undergone coronary angiography. A strong trend towards decline in readmission rates following ACS was observed between 2000 and 2013 (p<0.001). However, the association between readmission and poor long-term outcome was more pronounced among patients readmitted during more recent years (2008–2013).