Background and design of a ۵-year ST Elevation Myocardial Infarction Cohort in Isfahan, Iran: SEMI-CI study

BACKGROUND: Cardiovascular disease (CVD) is one of the most important causes of mortality and morbidity in Iran. Secondary prevention of acute myocardial infarction (AMI) is necessary. The main aim of this cohort is evaluating clinical, paraclinical, management, and ۵-year major events of the participants in Isfahan, Iran.METHODS: All consecutive patients with AMI hospitalized in Chamran Hospital, Isfahan, during ۱ year from march ۲۰۱۵ were recruited and followed for ۵ years. ST-Elevation Myocardial Infarction Cohort Study (SEMI-CI) has been initiated as a longitudinal study to evaluate course of patients with AMI in Iran, adherence to evidence-based secondary prevention drug, and five-year events such as death, re-myocardial infarction (REMI), re-hospitalization, congestive heart failure (CHF), and referring to another procedure [percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and resynchronization therapy].RESULTS: A total of ۸۶۷ patients with ST-elevation myocardial infarction (STEMI) with mean age of ۶۰.۹۱ ± ۱۲.۷۶ years were recruited. ۷۰۵ (۸۱.۳%) subjects were men with mean age of ۵۹.۶۳ ± ۱۲.۵۹ years. ۴۷۰ (۵۴.۲%) patients had anterior AMI (ant-AMI) and the rest had other types of AMI. The ejection fraction (EF) mean was ۳۷.۸۰ ± ۱۱.۷۴ percent. A total of ۳۰ (۳.۵%) cases of AMI had not received reperfusion. ۴۴۵ (۵۱.۴%) had primary PCI and ۳۹۲ (۴۵.۲%) had thrombolysis at first revascularization strategy. In-hospital death occurred in ۷۲ participants (۸.۳%). Drug during hospital included: at discharge, ۷۶۷ (۸۸.۵%) received aspirin, ۷۸۷ (۹۰.۷%) statin, ۶۹۷ (۸۰.۴%) beta-blocker, and ۴۸۰ (۵۵.۴%) angiotensin-converting enzyme (ACE) inhibitor.CONCLUSION: According to the best of our knowledge, it is among few cohorts in Eastern Mediterranean Region (EMR) in patients with AMI. This paper showed methodology of this study in patients with STEMI and its follow-up protocol. We can use this result in policy-making for improving secondary prevention strategies. 

Keywords:

Myocardial Infarction , Cohort Study , Secondary Prevention , Death