Higher risk for cardiac patients

About a third of heart attack patients also have an active, noncardiac condition that could warrant admission to the hospital, Yale researchers reported in the American Journal of Medicine in October. And patients who have acute conditions such as stroke, kidney failure and pneumonia may have poorer outcomes, according to first author Judith H. Lichtman, M.P.H. ’88, Ph.D., assistant professor of epidemiology. “Relatively little is known about the care and outcomes of heart attack patients who arrive at the hospital with an additional, active noncardiac condition.

Lichtman and colleagues studied 1,145 patients with acute myocardial infarction who were discharged from Yale-New Haven Hospital between January 1997 and June 2000, and rated the additional noncardiac conditions in these patients by severity. Life-threatening conditions included active bleeding, major stroke, metastatic cancer, abdominal aortic aneurysm rupture, acute psychosis, major trauma and others.

“More research is needed to describe these complex patients to identify opportunities to improve their clinical management,” said Lichtman.