{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T11:07:00Z","timestamp":1789556820901,"version":"build-2803163510"},"reference-count":21,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"unspecified","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2026,7,22]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Prolonged length of stay (LOS) contributes substantially to the healthcare burden in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI), yet large-scale evidence from Chinese populations remains limited. This study aimed to identify factors associated with prolonged LOS among AMI patients undergoing PCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were derived from the nationwide CCC-ACS (Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome) registry (November 2014 to December 2020). A total of 70\u2009209 AMI patients aged 18\u201380 years undergoing PCI were included. Prolonged LOS was defined as &gt;75th percentile. Multivariable logistic regression was used to identify independent predictors. Temporal trends in LOS from 2015 to 2020 were also assessed. Patients were further stratified by five pre-admission risk factors to assess dose\u2013response relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>LOS decreased in ST-segment elevation myocardial infarction from 2015 to 2017\u2009but remained stable thereafter, with no significant change in non-ST-segment elevation myocardial infarction. Female sex (OR=0.823), prior PCI (OR=0.745) and hyperlipidaemia (OR=0.917) were associated with a lower risk of prolonged LOS, whereas older age (OR=1.013), prior heart failure (OR=2.230), diabetes (OR=1.140) and transient ischaemic attack (OR=1.341) were independently associated with an increased risk of prolonged LOS (all p&lt;0.05). A significant dose\u2013response relationship was observed, with higher risk associated with increasing numbers of risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prolonged LOS among AMI patients undergoing PCI was associated with both baseline characteristics and in-hospital factors, with a clear cumulative effect, which may aid risk stratification and optimisation of in-hospital management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02306616\">NCT02306616<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  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