Recurrent myocardial infarction: In-Hospital mortality, cardiovascular complications, and comorbidity profiles
Abhinav Singh1, Nameer Ascandar2, Anton Lishmanov1
1Department of Internal Medicine, HCA Healthcare/USF Morsani College of Medicine GME: HCA Florida Bayonet Hospital, Hudson, FL, USA.
Current Problems in Cardiology
|February 26, 2026
Summary
Recurrent myocardial infarction (RMI) patients face higher in-hospital mortality and complications. This highlights the need for improved risk assessment and tailored treatments for these high-risk individuals.
Area of Science:
- Cardiology
- Clinical Medicine
- Health Services Research
Background:
- Advances in acute myocardial infarction (AMI) management increase survival but also the prevalence of patients with prior infarctions.
- Recurrent myocardial infarction (RMI) presents unique challenges and complications requiring specific clinical understanding.
- Identifying and managing high-risk patients with RMI is crucial for improving cardiovascular care outcomes.
Purpose of the Study:
- To compare clinical outcomes, complication rates, and comorbidity burden in patients hospitalized with RMI versus first-time AMI/NSTEMI.
- To assess the differential impact of recurrent events on patient health and healthcare resource utilization.
- To provide data supporting the development of targeted interventions for RMI patients.
Main Methods:
- Retrospective cohort study using the Nationwide Readmissions Database (2016-2022).
- Stratification of adult acute coronary syndrome admissions into RMI and non-RMI cohorts.
- Multivariable regression models adjusted for demographic and clinical factors to analyze outcomes.
Main Results:
- RMI patients (0.3% of AMI admissions) showed significantly increased adjusted risks for mortality (AOR 1.59), cardiac arrest (AOR 1.58), cardiogenic shock (AOR 1.96), and ventricular arrhythmias (AOR 1.91 for VF, 1.44 for VT).
- Utilization of temporary mechanical circulatory support (tMCS) was higher in RMI patients (AOR 2.16).
- RMI was associated with longer hospital stays (+2.46 days), higher costs (+$11,400), and greater prevalence of comorbidities like diabetes and kidney disease.
Conclusions:
- Recurrent myocardial infarction is independently linked to worse in-hospital outcomes and increased healthcare utilization compared to first-time events.
- There is an urgent need for enhanced risk stratification and tailored management strategies for RMI patients.
- Expanded access to advanced therapies is essential to address the complex needs of the RMI population.
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