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Observational Study
. 2015 Oct;128(10):1087-93.
doi: 10.1016/j.amjmed.2015.05.002. Epub 2015 May 23.

Characteristics of contemporary patients discharged from the hospital after an acute coronary syndrome

Robert J Goldberg  1 , Jane S Saczynski  2 , David D McManus  2 , Molly E Waring  3 , Richard McManus  3 , Jeroan Allison  3 , David C Parish  4 , Darleen Lessard  3 , Sharina Person  3 , Joel M Gore  2 , Catarina I Kiefe  3 ; TRACE-CORE investigators
Affiliations
Observational Study

Characteristics of contemporary patients discharged from the hospital after an acute coronary syndrome

Robert J Goldberg et al. Am J Med. 2015 Oct.

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.

Keywords: Acute coronary syndrome; Hospital treatment practices; Prospective observational study; Psychosocial characteristics.

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Conflict of interest statement

There are no conflicts of interests with any of the authors.

Figures

Figure 1
Figure 1
Figure 1a. Hospital Receipt of Cardiac Medications According to Initial Versus Recurrent Episode of Coronary Heart Disease: TRACE-CORE Figure 1b. Hospital Receipt of Cardiac Diagnostic and Interventional Procedures According to Initial Versus Recurrent Episode of Coronary Heart Disease: TRACE-CORE
Figure 1
Figure 1
Figure 1a. Hospital Receipt of Cardiac Medications According to Initial Versus Recurrent Episode of Coronary Heart Disease: TRACE-CORE Figure 1b. Hospital Receipt of Cardiac Diagnostic and Interventional Procedures According to Initial Versus Recurrent Episode of Coronary Heart Disease: TRACE-CORE
See this image and copyright information in PMC

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