Long Term Survival and Hospital Admission Following Acute Coronary Syndrome; a Cohort Study

Identification of survival predictors can be as a guide to formulate preventive strategies to reduce mortality. The purpose of this study was to identify factors affecting death and readmission due to acute coronary syndrome based on acute coronary syndrome registry in Kermanshah in 2010-2011. Data was collected according to the questionnaire used in Euro Heart Study-ACS Registry. For the purpose of this study, we used data recorded in patients’ medical files as well as interviews with doctors and patients if it was necessary. A nurse on collected all relevant data for each patient regarding prehospital history, hospital course and one year after discharge. To calculate survival and readmission of patients and the factors affecting on them COX regression was used. Of total 1972 people who were studied, 101 patients died during follow-up and 1030 patients were rehospitalized due to acute coronary syndrome or complications of heart diseases. The most important factors affecting survival and after adjustment for other factors, were age more than 75 years (HR = 14.90, 95% CI: 3.47 -63.85), female gender (HR = 1.38, 95% CI: 1.00-2.35), and chronic condition (HR = 2.42, 95% CI: 1.42-4.10). The most important predictors of readmission were also age less than 50 years (HR = 1.98, 95% CI: 1.52-2.59), male gender (HR = 1.17, 95% CI: 1.00-1.39) and having Q wave MI (HR = 1.22, 95% CI: 1.01-1.46). Women had higher mortality and lower readmission after ACS, the fact that need to be addressed in future health interventions. Other modifiable factors related with survival and hospital readmission need to be investigated and tackled in future studies and population based interventions.