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Reason for readmission following acute coronary syndrome episode code N[N]

Identifying and definitional attributes

Metadata item type:Help on this termValue Domain
METeOR identifier:Help on this term359408
Registration status:Help on this termHealth, Standard 01/10/2008
Definition:Help on this termA code set representing the main reason for the admission following a previous discharge from an acute coronary syndrome episode.

Representational attributes

Representation class:Help on this termCode
Data type:Help on this termNumber
Format:Help on this termN[N]
Maximum character length:Help on this term2
Permissible values:Help on this term
ValueMeaning
1ST-segment-elevation myocardial infarction
2non-ST-segment-elevation ACS with high-risk features
3non-ST-segment-elevation ACS with intermediate-risk features
4non-ST-segment-elevation ACS with low-risk features
5Percutaneous coronary intervention (PCI)
6Coronary artery bypass graft (CABG)
7Heart Failure (without MI)
8Arrhythmia (without MI)
Supplementary values:Help on this term
99Not stated/inadequately described

Collection and usage attributes

Guide for use:Help on this term

CODE 1     ST-segment-elevation myocardial infarction

This code is used when the reason for admission is persistent ST elevation of >=1mm in two contiguous limb leads, or ST elevation of >=2mm in two contiguous chest leads, or with new left bundle-branch block (BBB) pattern on the ECG.

CODE 2     Non-ST-segment-elevation ACS with high-risk features

This code is used when the reason for admission is clinical features consistent with an acute coronary syndrome with high-risk features which include any of the following:

  • repetitive or prolonged (> 10 minutes) ongoing chest pain or discomfort;
  • elevated level of at least one cardiac biomarker (troponin or creatine kinase-MB isoenzyme);
  • persistent or dynamic ECG changes of ST segment depression >= 0.5mm or new T wave >= 2mm;
  • transient ST-segment elevation (>= 0.5 mm) in more than 2 contiguous leads;
  • haemodynamic compromise: Blood pressure < 90 mmHg systolic, cool peripheries, diaphoresis, Killip Class > 1, and/or new onset mitral regurgitation;
  • sustained ventricular tachycardia;
  • syncope;
  • left ventricular systolic dysfunction (left ventricular ejection fraction < 0.40);
  • prior percutaneous coronary intervention within 6 months or prior coronary artery bypass surgery;
  • presence of known diabetes (with typical symptoms of ACS); or
  • chronic kidney disease (estimated glomerular filtration rate < 60mL/minute) (with typical symptoms of ACS).

CODE 3     Non-ST-segment-elevation ACS with intermediate-risk features

This code is used when the reason for admission is clinical features consistent with an acute coronary syndrome and any of the following intermediate-risk features AND NOT meeting the criteria for high-risk ACS:

  • chest pain or discomfort within the past 48 hours that occurred at rest, or was repetitive or prolonged (but currently resolved);
  • age greater than 65yrs;
  • known coronary heart disease: prior myocardial infarction with left ventricular ejection fraction >= 0.40, or known coronary lesion more than >50% stenosed;
  • no high-risk changes on electrocardiography (see high-risk features);
  • two or more of the following risk factors: of known hypertension, family history, active smoking or hyperlipidaemia;
  • presence of known diabetes (with atypical symptoms of ACS);
  • chronic kidney disease (estimated glomerular filtration rate < 60mL/minute) (with atypical symptoms of ACS); or
  • prior aspirin use.

CODE 4     Non-ST-segment-elevation ACS with low-risk features

This code is used when the reason for admission is clinical features consistent with an acute coronary syndrome without intermediate or high-risk features of non-ST-segment-elevation ACS. This includes onset of anginal symptoms within the last month, or worsening in severity or frequency of angina, or lowering of anginal threshold.

CODE 5     Percutaneous coronary intervention (PCI)

This code is used when the reason for admission is for a PCI, where the PCI is not immediately precipitated by a recurrent ischaemic event. If a recurrent ischaemic event precipitates a readmission with an associated PCI undertaken, one of codes 1-4 should be coded.

CODE 6     Coronary artery bypass graft (CABG)

This code is used when the reason for admission is for a CABG, where the CABG is not immediately precipitated by a recurrent ischaemic event. If a recurrent ischaemic event precipitates a readmission with an associated CABG undertaken, one of codes 1-4 should be coded.

CODE 7     Heart failure (without MI)

This code is used when the reason for admission is for the treatment of heart failure, where heart failure is not immediately precipitated by a recurrent ischaemic event. If a recurrent ischaemic event precipitates a readmission, one of codes 1-4 should be coded.

CODE 8     Arrhythmia (without MI)

This code is used when the reason for admission is for the treatment of an arrhythmia, where the arrhythmia is not immediately precipitated by a recurrent ischaemic event. If a recurrent ischaemic event precipitates a readmission, one of codes 1-4 should be coded.

Relational attributes

Related metadata references:Help on this term

Supersedes Reason for readmission following acute coronary syndrome episode code N[N] Health, Superseded 01/10/2008

Data elements implementing this value domain:Help on this term

Person—reason for readmission following acute coronary syndrome episode, code N[N] Health, Standard 01/10/2008

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