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Myocardial infarction (MI, heart attack) is the deterioration of heart tissue due to the cessation of blood supply which may result from a blood clot obstructing one of the coronary arteries, the major vessels supplying blood to the heart. Thrombolytic agents, such as tissue plasminogen activator (t-PA), which break down blood clots may be useful in the treatment of MI. Thrombolysis in Myocardial Infarction (TIMI) phase II is a multicenter study of 228 patients with MI who were treated with t-PA within four hours after the onset of symptoms. Within 18 to 48 hours after thrombolytic therapy, these patients underwent percutaneous transluminal coronary angioplasty, a procedure in which a balloon attached to a catheter, or flexible tube, is inserted into the narrowed portion of a coronary vessel and inflated to enlarge the vessel. The estimated six-week, six-month, and one-year rates of death or MI were 9, 13, and 14 percent, respectively. Most of the cardiac events, such as recurrent MI, occurred early during the follow-up period. Continuing chest pain after t-PA treatment, a history of congestive heart failure, low blood pressure at initial evaluation, and hypertension, or abnormally high blood pressure, increased the risks of death or recurrent MI. Patient age and history of chest discomfort influenced future hospitalization or the frequency of procedures to revascularize, or restore blood flow to the heart. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abstract Objective To estimate the relationship between comorbid serious mental illness (SMI) diagnosis and 30-day medical-surgical readmissions. Methods In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) we searched five databases (2012 to 2017) to identify relevant articles on the relationship between SMI diagnosis and readmissions. We used the National Institute of Health's Quality Appraisal Tool for Observational Cohort and Cross-Sectional Studies guidelines to appraise studies and assess risk of bias. Data were narratively synthesized and a pooled random effects unadjusted odds ratio was estimated using meta-analysis. Heterogeneity was investigated using subgroup analysis and meta-regression. Results Our search yielded 424 articles after removing duplicates. Nine met inclusion criteria. All studies were retrospective observational cohort studies. The meta-analysis showed that people with SMI have greater odds of readmission than people without SMI (pooled OR 1.38, CI 1.23–1.56, I2 = 98.6%). There was heterogeneity in patient cohorts, study methodology, and definition of SMI. No significant possibility of publication bias was detected (Classic fail-safe N = 3480). Conclusion There is a meaningful relationship between SMI diagnosis and medical-surgical readmissions. Given the prevalence of SMI in patients hospitalized for medical-surgical problems and the heterogeneity of evidence, further research on sources of variation in outcomes is critically needed. [ABSTRACT FROM AUTHOR]