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Identification and Characteristics of Low-Risk Survivors of an Acute Myocardial Infarction

  • Mayra Tisminetzky
    Affiliations
    Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts

    Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, Massachusetts

    Division of Geriatrics, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
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  • Jerry Gurwitz
    Affiliations
    Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts

    Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, Massachusetts

    Division of Geriatrics, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
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  • Han-Yang Chen
    Affiliations
    Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
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  • Nathaniel Erskine
    Affiliations
    Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
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  • Jorge Yarzebski
    Affiliations
    Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
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  • Joel Gore
    Affiliations
    Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts

    Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
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  • Darleen Lessard
    Affiliations
    Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
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  • Robert Goldberg
    Correspondence
    Corresponding author: Tel: (508) 856-3991; fax: (508) 856-8993.
    Affiliations
    Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts

    Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, Massachusetts

    Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
    Search for articles by this author
      There are limited contemporary data available describing the characteristics of patients who neither died nor were readmitted to the hospital during the first year after hospital discharge for an acute myocardial infarction (AMI) in comparison with those who died and/or were readmitted to the hospital during this high-risk period. Residents of the Worcester, Massachusetts, metropolitan area discharged after an AMI from 3 central Massachusetts hospitals on a biennial basis from 2001 to 2011 comprised the study population. The average age of this population (n = 4,268) was 69 years, 62% were men, and 92% were white. From 2001 to 2011, 43.5% of patients were classified as low-risk survivors of an AMI, 12.3% died, and 44.2% did not die but had at least 1 rehospitalization during the subsequent year. The proportion of low-risk survivors increased from 42.6% to 46.4%, whereas the proportion of those who died within a year after hospital discharge decreased from 14.3% to 10.5%, respectively, during the years under study. After adjusting for several patient characteristics, younger (≤65 years) persons, men, those who were married, those who did not present with multimorbidities, and patients who did not develop in-hospital clinical complications were more likely to be classified as a low-risk AMI survivor. Identifying low-risk survivors of an AMI may help health care providers to focus more intensive efforts and interventions on those at higher risk for dying and/or being readmitted to the hospital during the postdischarge transition period after an AMI.
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