Effect of previous stroke on quality of inpatient care and long-term mortality risk of non-ST-segment myocardial infarction

作者：Andrew Cole, Nicholas Weight, Mustafa Hussein Ajlan Al-Jarshawi, Muhammad Rashid, Mamas A. Mamas · 发表于：European Heart Journal Open · 年份：2025 · DOI：10.1093/ehjopen/oeaf143 · 被引用次数：2 · 研究领域：Acute Ischemic Stroke Management、Acute Myocardial Infarction Research、Cardiac Health and Mental Health

Aims: Individuals with a previous stroke face an increased risk of Non-ST-segment myocardial infarction (NSTEMI) and may have a higher associated mortality. However, the impact of inpatient care quality during the NSTEMI admission on long-term outcomes remains unclear. To assess whether there were disparities in care and NSTEMI clinical outcomes between individuals with and without a previous stroke. Methods and results: We analysed 425 274 adults hospitalized between January 2005 and March 2019, with NSTEMI from the UK Myocardial Ischaemia National Audit Project (MINAP) registry, linked with Office for National Statistics mortality reporting. We examined long-term outcomes by previous stroke status and inpatient care quality for patients that survived to discharge using the opportunity-based quality-indicator score (OBQI) score, categorized as 'poor', 'fair', 'good' or 'excellent'. Individuals with previous stroke were older (median age 79 vs. 72 years) and underwent revascularization by PCI (22% vs. 37%) less frequently than those without a previous stroke. The adjusted mortality risk for those with a previous stroke was higher at 30 days (aHR 1.14, 95% CI 1.10, 1.18), 1 year (aHR 1.20, 95% CI 1.17, 1.22) and 10 years (aHR 1.27, 95% CI 1.26 1.29) with higher quality inpatient care associated with lower mortality rates compared with poor care (good: HR 0.86, 95% CI 0.80, 0.92; excellent: HR 0.76, 95% CI 0.71, 0.81). Conclusion: Individuals with a previous stroke, experience ...