Long-Term Hospital Readmission after ST-Elevation Myocardial Infarction: A 3-Year Follow-up from the SEMI-CI Study
Parsa Tavassoli Naini1, Marjan Jamalian2, Ali Riahi1
1Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Identifying readmission risk factors after ST-elevation myocardial infarction (STEMI) is crucial for improving patient outcomes. Key predictors include elevated creatinine, lower shock index, heart failure, and reduced ejection fraction, guiding targeted interventions.
Area of Science:
- Cardiology
- Clinical Research
- Public Health
Background:
- ST-elevation myocardial infarction (STEMI) poses significant long-term risks, including hospital readmissions.
- Understanding readmission predictors is vital for post-MI patient management and healthcare resource optimization.
Purpose of the Study:
- To investigate the risk factors associated with cardiovascular readmission within three years following STEMI.
- To identify key clinical and demographic variables that predict readmission in STEMI patients.
Main Methods:
- Secondary analysis of the STEMI Cohort Study (SEMI-CI) involving 867 patients.
- Data collection included demographics, medical history, and clinical data at discharge, with 3-year follow-up via phone and in-person visits.
- Cardiovascular readmission defined as MI, unstable angina, stent thrombosis, stroke, or heart failure; analyzed using binary logistic regression.
Main Results:
- 30.27% of 773 patients experienced readmission within 3 years.
- Higher creatinine levels (OR, 1.73) and history of heart failure (OR, 1.78) increased readmission risk.
- Lower shock index (OR, 0.26) and reduced ejection fraction (OR, 0.97) were also significant predictors.
Conclusions:
- Elevated creatinine, heart failure, lower shock index, and reduced ejection fraction are significant predictors of 3-year readmission post-STEMI.
- Identifying high-risk patients allows for targeted interventions to reduce readmission rates.
- Routine clinical visits should focus on these identified risk factors to improve STEMI patient management.
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.
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