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Long-term prognostic significance of living alone and other risk factors in patients with acute myocardial infarction

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Abstract

Background

Living alone has been associated with higher risk of acute coronary syndrome in general population, but there are no consistent findings about its effect on prognosis after acute myocardial infarction (AMI).

Aim

To analyse the relationships between living alone and other risk factors at baseline and long-term survival after AMI.

Methods

One hundred and thirty-five patients with confirmed myocardial infarction (MI) admitted to the coronary care unit of the Institute of Cardiovascular Diseases, Clinical Centre of Serbia in Belgrade, between June 2002 and April 2006, were followed up until September 2011. Survival time was estimated using the Kaplan–Meier method and Cox regression analysis.

Results

Patients with MI were followed up for a median of 77 months. The mean age of participants was 57.82 years (SD ± 10.8), and one quarter of them were women. According to the multivariate Cox regression analysis stratified on marital status, the model in which were included living alone, age, gender, education, obesity, smoking, hyperlipidaemia, hypertension, diabetes mellitus, previous cardiovascular and other disease, thrombolytic therapy and localisation of MI, the following variables were found to be independent predictors of death after AMI: living alone, with a hazard ratio (HR) of 7.60 [95 % confidence interval (CI) 1.99–29.08], diabetes mellitus (HR 3.31; 95 % CI 1.33–8.23), current smoking (HR 2.82; 95 % CI 1.03–7.71) and, older age (HR 1.13; 95 % CI 1.06–1.19).

Conclusion

The results of this study support hypothesis that patients who live alone have higher long-term all-cause mortality following AMI.

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References

  1. Alter DA, Chong A, Austin PC et al (2006) Socioeconomic status and mortality after acute myocardial infarction. Ann Intern Med 144:82–93

    Article  PubMed  Google Scholar 

  2. Rozanski A, Blumenthal JA, Davidson KW et al (2005) The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging field of behavioral cardiology. J Am Coll Cardiol 45:637–651

    Article  PubMed  Google Scholar 

  3. Kristofferzon M-L, Löfmark R, Carlsson M (2005) Coping, social support and quality of life over time after myocardial infarction. J Adv Nurs 52:113–124

    Article  PubMed  Google Scholar 

  4. Bucholz EM, Rathore SS, Gosch K et al (2011) Effect of living alone on patient outcomes after hospitalisation for acute myocardial infarction. Am J Cardiol 108:943–948

    Article  PubMed Central  PubMed  Google Scholar 

  5. Lammintausta A, Airaksinen JK, Immonen-Räihä P et al (2013) Prognosis of acute coronary events is worse in patients living alone: the FINAMI myocardial infarction register. Eur J Prev Cardiol. (Epub ahead of print)

  6. Schmaltz HN, Southern D, Ghali WA et al (2007) Living alone, patient sex and mortality after acute myocardial infarction. J Gen Intern Med 22:572–578

    Article  PubMed Central  PubMed  Google Scholar 

  7. O’Shea JC, Wilcox RG, Skene AM et al (2002) Comparison of outcomes of patients with myocardial infarction when living alone versus those not living alone. Am J Cardiol 90:1374–1377

    Article  PubMed  Google Scholar 

  8. Berkman LF, Leo-Summers L, Horwitz RI (1992) Emotional support and survival after myocardial infarction: a prospective, population-based study of the elderly. Ann Intern Med 117:1003–1009

    Article  CAS  PubMed  Google Scholar 

  9. Case RB, Moss AJ, Case N et al (1992) Living alone after myocardial infarction: impact on prognosis. JAMA 267:515–519

    Article  CAS  PubMed  Google Scholar 

  10. Machón M, Basterretxea M, Martínez-Camblor P et al (2010) Sex differences in relative survival and prognostic factors in patients with a first acute myocardial infarction in Guipuzcoa, Spain. Rev Esp Cardiol 63:649–659

    Article  PubMed  Google Scholar 

  11. Kandler U, Meisinger C, Baumert J et al (2007) Living alone is a risk factor for mortality in men but not women from the general population: a prospective cohort study. BMC Public Health 7:335

    Article  PubMed Central  PubMed  Google Scholar 

  12. Statistical Office of the Republic of Serbia (2013) Households according to the number of members. Statistical Office of the Republic of Serbia, Belgrade

    Google Scholar 

  13. Tunstall-Pedoe H, Kuulasmaa K, Amouyel P et al (1994) Myocardial infarction and coronary deaths in the World Health Organisation MONICA projects. Registration procedures, event rates, and case fatality rates in 38 population from 21 countries in four continents. Circulation 90:583–612

    Article  CAS  PubMed  Google Scholar 

  14. World Health Organization (2004) Obesity: preventing and managing the global epidemic report of a WHO Consultation. WHO, Geneva

    Google Scholar 

  15. Kleinbaum DG, Klein M (2012) Survival analysis: a self-learning text, 3rd edn. Springer Science + Business Media, LLC, New York

    Book  Google Scholar 

  16. Nielsen FE, Mard S (2010) Single-living is associated with increased risk of long-term mortality among employed patients with acute myocardial infarction. Clin Epidemiol 2:91–98

    Article  PubMed Central  PubMed  Google Scholar 

  17. Norekvål TM, Fridlund B, Rokne B et al (2010) Patient-reported outcomes as predictors of 10-year survival in women after acute myocardial infarction. Health Qual Life Outcomes 8:140

    Article  PubMed Central  PubMed  Google Scholar 

  18. Frasure-Smith N, Lespérance F, Gravel G et al (2000) Social support, depression, and mortality during the first year after myocardial infarction. Circulation 101:1919–1924

    Article  CAS  PubMed  Google Scholar 

  19. Fioretti P, Baardman T, Deckers J et al (1988) Social fate and long-term survival of patients with a recent myocardial infarction, after cardiac rehabilitation. Eur Heart J 9(Suppl L):89–94

    Article  PubMed  Google Scholar 

  20. Nielsen KM, Faergeman O, Larsen ML et al (2006) Danish singles have a twofold risk of acute coronary syndrome: data from a cohort of 138 290 persons. J Epidemiol Community Health 60:721–728

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Mookadam F, Arthur HM (2004) Social support and its relationship to morbidity and mortality after acute myocardial infarction: systematic overview. Arch Intern Med 164:1514–1518

    Article  PubMed  Google Scholar 

  22. Gruppetta M, Calleja N, Fava S (2010) Long-term survival after acute myocardial infarction and relation to type 2 diabetes and other risk factors. Clin Cardiol 33:424–429

    Article  PubMed  Google Scholar 

  23. Gerward S, Tydén P, Engström G et al (2010) Marital status and occupation in relation to short-term case fatality after a first coronary event—a population based cohort. BMC Public Health 10:235

    Article  PubMed Central  PubMed  Google Scholar 

  24. Lund R, Due P, Modvig J et al (2002) Cohabitation and marital status as predictors of mortality—an eight year follow-up study. Soc Sci Med 55:673–679

    Article  PubMed  Google Scholar 

  25. Hadi Khafaji HA, Al Habib K, Asaad N et al (2012) Marital status and outcome of patients presenting with acute coronary syndrome: an observational report. Clin Cardiol 35:741–748

    Article  PubMed  Google Scholar 

  26. Strike PC, Steptoe A (2004) Psychosocial factors in the development of coronary artery disease. Prog Cardiovasc Dis 46:337–347

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was supported by the Ministry for Science and Technology of the Republic of Serbia, through contract number 175042 (2011–2014).

Conflict of interest

Dr. Vujcic has nothing to disclose.

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Authors and Affiliations

  1. Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26a, 11000, Belgrade, Serbia

    I. Vujcic, H. Vlajinac, J. Maksimovic & S. Sipetic

  2. Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    E. Dubljanin

  3. Institute of Cardiovascular Diseases, Clinical Centre of Serbia, Belgrade, Serbia

    Z. Vasiljevic

  4. Clinic for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Belgrade, Serbia

    D. Matanovic

  5. Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    J. Marinkovic

Authors
  1. I. Vujcic
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  2. H. Vlajinac
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  3. E. Dubljanin
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  4. Z. Vasiljevic
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  5. D. Matanovic
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  6. J. Maksimovic
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  7. S. Sipetic
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  8. J. Marinkovic
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Correspondence to I. Vujcic.

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Vujcic, I., Vlajinac, H., Dubljanin, E. et al. Long-term prognostic significance of living alone and other risk factors in patients with acute myocardial infarction. Ir J Med Sci 184, 153–158 (2015). https://doi.org/10.1007/s11845-014-1079-2

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  • DOI: https://doi.org/10.1007/s11845-014-1079-2

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