Young Women With Acute Myocardial Infarction: Risk Prediction Model for 1-Year Hospital Readmission

Rachel P. Dreyer, Andrew Arakaki, Valeria Raparelli, Terrence E. Murphy, Sui W. Tsang, Gail D'Onofrio, Malissa Wood, Catherine X. Wright, Louise Pilote

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Although young women ( aged ≤ 55 years) are at higher risk than similarly aged men for hospital readmission within 1 year after an acute myocardial infarction (AMI), no risk prediction models have been developed for them. The present study developed and internally validated a risk prediction model of 1-year post-AMI hospital readmission among young women that considered demographic, clinical, and gender-related variables. Methods: We used data from the US Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study (n = 2007 women), a prospective observational study of young patients hospitalized with AMI. Bayesian model averaging was used for model selection and bootstrapping for internal validation. Model calibration and discrimination were respectively assessed with calibration plots and area under the curve. Results: Within 1-year post-AMI, 684 women (34.1%) were readmitted to the hospital at least once. The final model predictors included: any in-hospital complication, baseline perceived physical health, obstructive coronary artery disease, diabetes, history of congestive heart failure, low income ( < $30,000 US), depressive symptoms, length of hospital stay, and race (White vs Black). Of the 9 retained predictors, 3 were gender-related. The model was well calibrated and exhibited modest discrimination (area under the curve = 0.66). Conclusions: Our female-specific risk model was developed and internally validated in a cohort of young female patients hospitalized with AMI and can be used to predict risk of readmission. Whereas clinical factors were the strongest predictors, the model included several gender-related variables (ie, perceived physical health, depression, income level). However, discrimination was modest, indicating that other unmeasured factors contribute to variability in hospital readmission risk among younger women.

Original languageEnglish (US)
Pages (from-to)335-344
Number of pages10
JournalCJC Open
Volume5
Issue number5
DOIs
StatePublished - May 2023

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this