Clinical characteristics and admission diagnoses in patients with previous ischemic heart disease admitted to CICU

Follow-up of patients with ischemic heart disease (IHD) represents a substantial proportion of cases seen in outpatient cardiology clinics, reflecting the chronic and progressive nature of the disease. Despite advances in medical therapy and revascularization techniques, these patients remain at high risk for acute decompensation, recurrent ischemic events, and other cardiovascular complications. Understanding the factors leading to readmission to a Cardiac Intensive Care Unit (CICU) is crucial for improving patient management, optimizing resource utilization, and preventing adverse outcomes.

To describe the clinical characteristics, cardiovascular risk factor profile, and admission diagnoses of patients with previous ischaemic heart disease admitted to our Cardiac Intensive Care Unit between 2012 and 2024

A retrospective analysis was performed on a total of 7,359 patients admitted to the CICU at our center between 2012 and 2024, of whom 1,555 patients (21.13%) had a prior diagnosis of ischemic heart disease.

A total of 1,247 men (80.2%) and 308 women (19.8%) were included, with a mean age at admission of 72.2 ± 11.06 years. Regarding risk factors, 85% were hypertensive, 51.2% were diabetic—with a mean HbA1c of 6.8 ± 3.4%—and 78.1% had dyslipidemia, with a mean LDL cholesterol level of 70 ± 33 mg/dL. Additionally, 17.2% continued to smoke actively. Among the most frequent diagnoses, ST-segment elevation myocardial infarction (STEMI) was the most common, occurring in 384 patients (24.7%), followed by non-ST-segment elevation myocardial infarction (NSTEMI) in 483 patients (31.1%). Less frequent diagnoses included acute heart failure (152 patients, 9.8%), ventricular arrhythmias (119 patients, 7.7%), and atrioventricular blocks (84 patients, 5.4%).

In summary, patients with previous ischemic heart disease admitted to cardiac ICU show a high prevalence of cardiovascular risk factors, most of which are poorly controlled. This contributes to a high rate of readmissions due to predominantly recurrent acute coronary syndromes, with a smaller proportion attributable to heart failure and ventricular arrhythmias. Persistent smoking in 17% despite established coronary disease reflects critical failure of secondary prevention strategies.