Emotional Distress in Younger (<55 Years) and Older (≥55) Patients After a First-Time Myocardial Infarction and Its Prospective Associations With Working Status and Secondary Preventive Goals Among the Younger Cohort

BACKGROUND: Research has shown that younger patients who have had a myocardial infarction (MI) experience more emotional distress than their older counterparts. OBJECTIVE: In this study, we aimed to compare emotional distress 2 months post-MI (follow-up 1) between younger (<55) vs older (≥55) patients in Sweden, and investigate its impact on working status and 4 secondary preventive goals 1 year after MI (follow-up 2). METHODS: Data (N = 50 213) from the SWEDEHEART National Quality Registers for Cardiac Care, which covers approximately 90% of all MIs in Sweden, were used. RESULTS: After adjusting for confounders, logistic regression analyses showed that younger patients who had experienced an MI had higher odds of experiencing emotional distress than older patients at follow-up 1 (adjusted odds ratio [AOR], 1.59; 95% confidence interval [CI], 1.52-1.67) and follow-up 2 (AOR, 1.47; 95% CI, 1.40-1.55). Emotional distress at follow-up 1 was associated with lower odds of working (AOR, 0.60; 95% CI, 0.53-0.67) and achieving smoking and physical activity goals (AOR, 0.76; 95% CI, 0.67-0.86; AOR, 0.83; 95% CI, 0.76-0.91) at follow-up 2. However, emotional distress was not associated with achieving goals for low-density lipoproteins or systolic blood pressure at follow-up 2. CONCLUSIONS: Younger patients experienced emotional distress more often after a first-time MI than their older counterparts, and their distress predicted long-term lower levels of returning to work and achievement of smoking and physical activity goals. The results highlight the importance of identifying younger patients who have had an MI and are experiencing emotional distress, and offering them interventions targeting distress.