Context Thirty day readmission rates have become a publicly reported quality performance measure for congestive heart failure (CHF), acute myocardial infarction (AMI), and percutaneous coronary intervention (PCI). However, little is known regarding the factors associated with 30-day readmission after PCI. Objective To assess the demographic, clinical, and procedural factors associated with 30-day readmission rates after PCI. Design, Setting, and Patients We identified 15,498 PCI hospitalizations (elective or for acute coronary syndromes) from January 1998 through June 2008 at Saint Marys Hospital, Rochester, MN. All were included in this analysis. Multivariable logistic regression models were employed to estimate the adjusted association between demographic, clinical, and procedural variables and 30-day readmission. The association between 30-day readmission and 1-year mortality was estimated using Cox proportional hazards models with readmission as a time dependent covariate and by using landmark analysis. Main Outcome Measure(s) All-cause 30-day readmission to any hospital following PCI and 1-year mortality. Results Overall, 9.4% of PCIs (n=1,459) were readmitted and 0.68% (n=106) of PCIs resulted in death within 30-days after discharge. After multivariable analysis, female sex, Medicare insurance, less than a high school education, unstable angina, cerebrovascular accident/transient ischemic attack (CVA/TIA), moderate/severe renal disease, chronic obstructive pulmonary disease (COPD), peptic ulcer disease, metastatic cancer, and a length of stay >3 days were associated with an increased risk of 30-day readmission after PCI. Thirty-day readmission after PCI was associated with a higher risk of 1-year mortality (adjusted HR=1.38; 95% CI: 1.08–1.75; p=0.009). Conclusions Nearly 1 in 10 patients undergoing PCI were readmitted within 30-days. Thirty-day readmission after PCI was associated with a higher risk of 1-year mortality.

CTOP type I lesions were easiest to cross in antegrade fashion and type IV the most difficult. Lesion length >10 cm, severe calcification, and CTO types II, III, and IV benefited from the addition of retrograde tibiopedal access.

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Peripheral arterial disease (PAD), a relatively common manifestation of atherosclerotic vascular disease, is associated with significant morbidity and mortality. Although conventional risk factors contribute to the onset and progression of PAD, the role of 'novel' biomarkers in pathways of inflammation, thrombosis, lipoprotein metabolism, and oxidative stress in determining susceptibility to PAD is being increasingly recognized. Validation of novel risk factors for PAD may allow earlier detection, an improved understanding of disease etiology and progression, and the development of new therapies. In this review, we discuss available evidence for associations between novel circulating markers and several aspects of PAD including disease susceptibility, progression, functional limitation, and adverse outcomes.