Factors associated with re-hospitalization and status of risk factors among patients with stable coronary artery disease referred to Medical therapy: Unmatched cohort study

Abstract

Background: All patients with stable coronary artery diseases (CAD) require medical therapy (MT) to prevent disease progression and recurrent cardiovascular events, alleviate symptoms, and reduce mortality. Nonetheless, little is known about the clinical outcomes of unrevascularized patients taking MT for stable coronary artery disease and the status of coronary artery disease (CAD) risk factor control in Iran Objective: This study aims to evaluate the impact of medical therapy in unrevascularized CAD patients on risk factor modification and re-hospitalization among patients referred to the Rajaie Cardiovascular Medical and Research Center. Methods: An unmatched cohort study was conducted to collect demographic, risk factors, comorbidity, and re-hospitalization data about stable CAD patients in 2014 and followed until 2021. A multivariate regression analysis was applied to explore the relationship between re-hospitalization as the dependent variable and independent variables. Results: 290 stable CAD patients were included in our cohort. More than 60% were males. The mean age of participants was (55.9±5.4) years. Being male, AOR = 0.513 (95% CI, 0.24 – 0.85, p= 0.048); hypercholesterolemia, AOR = 4.10 (95% CI, 1.07 – 15.62, p= 0.040); ejection fraction below 40%, AOR = 4.05 (95% CI, 1.50 – 10.97, p= 0.006); current smoker, AOR = 2.18 (95% CI,1.03 – 4.62, p= 0.042); three-vessel involvement AOR = 10.39 (95% CI, 2.37-45.77, p=0.002) were independently associated with re-hospitalization. Conclusion: Gaps were identified concerning CAD risk factor control. Higher re-hospitalization was associated with female gender, smoking, presence of hypercholesterolemia, and reduced ejection fraction. Therefore, improving health lifestyle modification interventions tailored to individual patients with a particular focus on females is essential.