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Long-Term Hospital Readmission After St-Elevation Myocardial Infarction: A 3-Year Follow-Up From the Semi-Ci Study



Naini PT1 ; Jamalian M2 ; Riahi A1 ; Roohafza HR1 ; Soleimani A3 ; Shafiei M4 ; Agharazi M5 ; Sadeghi M2
Authors
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Authors Affiliations
  1. 1. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Chamran Cardiovascular and Medical Research Hospital, Isfahan University of Medical Science, Isfahan, Iran
  5. 5. Interventional Cardiology Research Center, Cardiovascular Research Institute, School of medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Tehran University Heart Center Published:2022

Abstract

Background: This study aimed to investigate readmission risk factors after ST-elevation myocardial infarction (STEMI) during a 3-year follow-up. Methods: This study is a secondary analysis of the STEMI Cohort Study (SEMI-CI) in Isfahan, Iran, with 867 patients. A trained nurse gathered the demographic, medical history, laboratory, and clinical data at discharge. Then the patients were followed up annually for 3 years by telephone and invitation for in-person visits with a cardiologist concerning readmission status. Cardiovascular readmission was defined as MI, unstable angina, stent thrombosis, stroke, and heart failure. Adjusted and unadjusted binary logistic regression analyses were applied. Results: Of 773 patients with complete information, 234 patients (30.27%) experienced 3-year readmission. The mean age of the patients was 60.92±12.77 years, and 705 patients (81.3%) were males. The unadjusted results showed that smokers were 21% more likely to be readmitted than nonsmokers (OR, 1.21; P=0.015). Readmitted patients had a 26% lower shock index (OR, 0.26; P=0.047), and ejection fraction had a conservative effect (OR, 0.97; P<0.05). The creatinine level was 68% higher in patients with readmission. An adjusted model based on age and sex showed that the creatinine level (OR, 1.73), the shock index (OR, 0.26), heart failure (OR, 1.78), and ejection fraction (OR, 0.97) were significantly different between the 2 groups. Conclusion: Patients at risk of readmission should be identified and carefully visited by specialists to help improve timely treatment and reduce readmissions. Therefore, it is recommended to pay special attention to factors affecting readmission in the routine visits of STEMI patients. © 2022 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.
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