Causes and Predictors of 30‐Day Readmission in Patients With COVID‐19 and ST‐Segment–Elevation Myocardial Infarction in the United States: A Nationwide Readmission Database Analysis

Abstract

Background Rates, causes, and predictors of readmission in patients with ST‐segment–elevation myocardial infarction (STEMI) during COVID‐19 pandemic are unknown. Methods and Results All hospitalizations for STEMI were selected from the US Nationwide Readmissions Database 2020 and were stratified by the presence of COVID‐19. Primary outcome was 30‐day readmission. Multivariable hierarchical generalized logistic regression analysis was performed to compare 30‐day readmission between patients with STEMI with and without COVID‐19 and to identify the predictors of 30‐day readmissions in patients with STEMI and COVID‐19. The rate of 30‐day all‐cause readmission was 11.4% in patients with STEMI who had COVID‐19 and 10.6% in those without COVID‐19, with the adjusted odds ratio (OR) not being significantly different between the two groups (OR, 0.88 [95% CI, 0.73–1.07], P =0.200). Of all 30‐day readmissions in patients with STEMI and COVID‐19, 41% were for cardiac causes. Among the cardiac causes, 56% were secondary to acute coronary syndrome, while among the noncardiac causes, infections were the most prevalent. Among the causes of 30‐day readmissions, infectious causes were significantly higher for patients with STEMI who had COVID‐19 compared with those without COVID‐19 (29.9% versus 11.3%, P =0.001). In a multivariable model, congestive heart failure, chronic kidney disease, low median household income, and length of stay ≥5 days were found to be associated with an increased risk of 30‐day readmission. Conclusions Post‐STEMI, 30‐day readmission rates were similar between patients with and without COVID‐19. Cardiac causes were the most common causes for 30‐day readmissions, and infections were the most prevalent noncardiac causes.