Long-Term Hospital Readmission after ST-Elevation Myocardial Infarction: A 3-Year Follow-up from the SEMI-CI Study

Parsa  Tavassoli Naini; Marjan Jamalian; Ali Riahi; Hamid  Reza  Roohafza; Azam Soleimani; Mohammadreza Shafiei; Mohammad Agharazi; Masoumeh Sadeghi

doi:10.18502/jthc.v17i4.11612

Parsa Tavassoli Naini Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Marjan Jamalian Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Ali Riahi Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Hamid Reza Roohafza Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Azam Soleimani Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammadreza Shafiei Chamran Cardiovascular and Medical Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammad Agharazi Interventional Cardiology Research Center, Cardiovascular Research Institute, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Masoumeh Sadeghi Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

DOI: https://doi.org/10.18502/jthc.v17i4.11612

Keywords: ST-elevation myocardial infarction; Hospital readmission; Risk factors

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.