Impact of off-hour admission on the MACEs of patients with acute myocardial infarction

Abstract

Background In China, on more than 100 weekends or holidays, only on-duty cardiologists are available during admissions. This study aimed to analyze the impact of admission time on major adverse cardiovascular events (MACEs) in patients with acute myocardial infarction (AMI). Methods This prospective observational study enrolled patients with AMI between October 2018 and July 2019. The patients were assorted into off-hour (admitted on weekends or national holidays) and on-hour groups. The outcome was MACEs at admission and 1 year after discharge. Results A total of 485 patients with AMI were enrolled in this study. The occurrence of MACEs was significantly higher in the off-hour group compared with the on-hour group (P < .05). Multivariate regression analysis showed that age (HR = 1.047, 95% CI: 1.021–1.073), blood glucose level (HR = 1.029, 95% CI: 1.009–1.050), multivessel disease (HR = 1.904, 95% CI: 1.074–3.375), and off-hour hospital admission (HR = 1.849, 95% CI: 1.125–3.039) were all independent risk factors for in-hospital MACEs, while percutaneous coronary intervention (HR = 0.210, 95% CI: 0.147–0.300) and on-hour admission (HR = 0.723, 95% CI: 0.532–0.984) were protective factors for MACEs 1 year after discharge. Conclusion The “off-hour effect” still existed in patients with AMI, and the risk of MACEs in the hospital and 1 year after discharge was higher for off-hour admission.

Keywords

• china
• myocardial infarction
• off-hour
• percutaneous coronary intervention
• risk factor