abspara0015">Consecutive STEMI patients, who received primary PCI at 1 of 4 PCI hospitals in Toronto, Canada between 2010 and 2012 were identified. Patients with shock or who died within 24 hours of presentation were excluded. Outcomes of interest were all-cause mortality and readmission for recurrent myocardial infarction (MI) at 1 year. To account for confounding because of the observational nature of our data, propensity score-matched pairs of patients who were repatriated vs nonrepatriated were identified.
abspara0020">Using the propensity score, 430 well matched pairs were identified, representing our cohort. There was no significant difference between repatriated and nonrepatriated groups in 1-year mortality (repatriated: 6.7%, nonrepatriated: 5.6%, hazard ratio, 1.18; 95% confidence interval, 0.69-2.03; P = 0.545). The 1-year readmission rates for MI were significantly greater for the repatriated group compared with the nonrepatriated group (repatriated: 12.1%; nonrepatriated: 5.8%; hazard ratio, 2.09; 95% confidence interval, 1.30-3.36; P = 0.002).
abspara0025">A strategy of early repatriation of STEMI patients was associated with a greater rate of readmission for MI. Our study raises questions regarding the safety of an early repatriation strategy that merit further research.