After an acute MI, SCAD readmissions are common, especially in young women.

ichhori team
After Acute MI & SCAD Readmissions Are Common, Especially in Younger Women

After Acute MI & SCAD Readmissions Are Common, Especially in Younger Women

Hospital readmissions within 30 days following acute myocardial infarction (AMI) associated with spontaneous coronary artery dissection (SCAD) occur at notable rates. A national database analysis of 2,654,087 AMI patients (2010–2015), including 1,386 SCAD cases, revealed a 12.3% readmission rate in SCAD vs. 9.9% in non‑SCAD cohorts. SCAD was independently linked to higher early readmission risk (OR 1.19) :contentReference[oaicite:2]{index=2}.

Key Findings

  • Timeframe: Half of SCAD-related readmissions happened within the first week post-discharge; over 50% of recurrent AMI occurred in the first two days :contentReference[oaicite:3]{index=3}.
  • Causes: 80% of SCAD readmissions were due to cardiac issues—most commonly recurrent MI (≈45%), followed by chest pain (≈20%) and arrhythmias (≈13%) :contentReference[oaicite:4]{index=4}.
  • Demographics: SCAD occurs more often in younger, healthier women with fewer traditional risk factors; those with STEMI and/or who underwent PCI had higher readmission rates :contentReference[oaicite:5]{index=5}.
  • Other predictors: Prior history of heart failure, renal dysfunction, COPD, and previous MI also increased readmission risk :contentReference[oaicite:6]{index=6}.
  • Research gaps: Lack of randomized trials limits targeted treatments, and there’s a need for better identification of high-risk individuals and preventive strategies :contentReference[oaicite:7]{index=7}.

Why It Matters

SCAD patients, despite often being younger and ostensibly healthier, face elevated early readmission risk following discharge. Early cardiac causes predominate, emphasizing the importance of close follow-up and tailored discharge planning.

Recommendations for Care

  1. Enhanced post-discharge surveillance—especially within the first week.
  2. Consider conservative vs. PCI approaches carefully in SCAD-related MI.
  3. Focus on comorbidity management: heart failure, renal disease, COPD.
  4. Promote cardiac rehabilitation and tailored recovery plans for SCAD patients.

Conclusion

Readmissions after acute MI complicated by SCAD occur early and frequently, with cardiac causes overwhelmingly likely. Younger women with STEMI presentations and those undergoing PCI are at particular risk. Filling current evidence gaps around SCAD-specific management is essential.

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