Coronary disease & ACSSecondary analysis
Incidence, Predictors, and Impact of Hospital Readmission After Revascularization for Left Main Coronary Disease
- Secondary analysis of the EXCEL randomised trial
Authors' conclusion
In the EXCEL trial, readmissions during 5-year follow-up after revascularization for LMCAD were common and more frequent after PCI than CABG. Readmissions were associated with an increased risk of all-cause death, more so after PCI than with CABG.
Study context
- Population
- Patients with left main CAD randomised to percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG)1,882 hospital survivors
- Participants
- 1,905 patients
- Comparison
- PCI vs CABG
- PCIn = 942
- CABGn = 940reference
- Primary endpoint
- Incidence, predictors and clinical impact of readmissions
- Follow-up
- 5 years
Primary result
One or more readmissions
Adjusted hazard ratio
1.22
95% CI 1.10–1.35
P < 0.0001
Events by treatment group
PCI vs CABG
adjusted HR 1.22 (95% CI 1.10–1.35); P < 0.0001
As reported in the abstract
- Readmissions overall: 1,868 in 851 of 1,882 hospital survivors
- 45.2%
- Readmissions per patient with readmission(s), mean ± SD (range 1-16)
- 2.2 ± 1.9
- Cardiovascular causes
- 927 [49.6%]
- Noncardiovascular causes
- 941 [50.4%]
Further findings
| Outcome | adjusted HR (95% CI) | |
|---|---|---|
| Subsequent all-cause death after readmission · 5 years — Readmission vs CABG · after PCI | 5.72 (3.42–9.55) | |
| Subsequent all-cause death after readmission · 5 years — Readmission vs CABG · after CABG | 2.72 (1.64–4.88) | |
| 0.10.31310Adjusted hazard ratio (log scale) |
- Subsequent all-cause death after readmission: interaction Pint = 0.03
Original publication
Incidence, Predictors, and Impact of Hospital Readmission After Revascularization for Left Main Coronary Disease. J Am Coll Cardiol. Published 19 March 2024. doi:10.1016/j.jacc.2024.01.012
Summarised from the published abstract; every number is checked against it