Factors Associated with Re-hospitalization and Status of Risk Factors among Patients with Stable Coronary Artery Disease Referring for Medical Therapy: An Unmatched Cohort Study

Background: All patients with stable coronary artery diseases (CADs) 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 CAD and the status of CAD risk factor control in Iran. Objectives: This study aimed to evaluate the impact of MT in unrevascularized CAD patients on risk factor modification and re-hospitalization among patients referring to the Rajaie Cardiovascular Medical and Research Center, Tehran, Iran. Methods: This 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 rehospitalization as the dependent variable and independent variables. Results: A total of 290 stable CAD patients were included in our cohort. More than 60% of the subjects were male. The mean age of the participants was obtained at 55.9 +/- 5.4 years. It was revealed that being male (adjusted odds ratio [AOR]=0.513, 95% confidence interval [CI], 0.24-0.85, P=0.048), having hypercholesterolemia (AOR=4.10, 95% CI, 1.07-15.62, P=0.040), having an ejection fraction of below 40% (AOR=4.05, 95% CI, 1.50-10.97, P=0.006), being a current smoker (AOR=2.18, 95% CI, 1.03-4.62, P=0.042), and involving three vessels (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 hypercholesterolemia, and reduced ejection fraction. Therefore, it is essential to improve healthy lifestyle modification interventions tailored to individual patients with a particular focus on females.