Key result
Diabetes and heart failure linked to lower return-to-work odds post-AMI, with diabetes reducing odds ~35%.
Why the study?
The incidence of young AMI is increasing and return-to-work is a key psycho-social recovery indicator, but factors influencing return-to-work after AMI remain undetermined.
What are the rates and factors associated with return-to-work among patients after acute myocardial infarction?
Systematic Review
What are the rates and factors associated with return-to-work among patients after acute myocardial infarction?
Odds Ratio: 0.65 (95% CI 0.46–0.93)
More than half of patients return to work by 3 months post-AMI, peaking at 1 year, but comorbidities like diabetes, heart failure, and depression significantly reduce the likelihood of returning to work.
Diabetes may warrant targeted return-to-work support post-AMI; extends observational evidence on negative predictors but leaves causality open.
BACKGROUND: The incidence of young acute myocardial infarction (AMI) is increasing. Return-to-work is an important indicator for patients' psycho-social recovery. However, factors influencing return-to-work after AMI are yet to be determined. OBJECTIVE: To summary available evidence on rate and factors associated with return-to-work among AMI patients. METHODS: The Cochrane Library, PubMed, Embase, Web of Science, Scopes and two Chinese databases (CNKI and VIP) were searched from inception to October 3, 2023. Pooled rate of return-to-work (%) and odds ratio (OR) were calculated with Stata 17 software. RESULTS: Of 2403 records screened, 19 studies were included. Pooled rate of return-to-work at 3, 6, 12, and 24 and above months after AMI was 74%, 87%, 87%, 80% respectively. Factors associated with lower rate of return-to-work were comorbidity of diabetes (OR = 0.65; 95% CI, 0.46-0.93), history of heart failure (OR = 0.43; 95% CI, 0.23-0.80), manual labor (OR = 0.51; 95% CI, 0.35-0.76) and depression (OR = 0.59; 95% CI, 0.37-0.93). Male (OR = 1.42; 95% CI, 1.09-1.85) and higher education level (OR = 1.45; 95% CI, 1.25-1.69) were protective factors. Age, marital status and smoking were not significantly associated with return-to-work. CONCLUSIONS: More than half of patients could return to work at 3-month post-AMI, return-to-work rate was increased during one-year post-AMI followed by a decrease. Comorbidity of diabetes, history of heart failure, manual labor and depression were negative predictors of return-to-work, while male and higher education level were protective factors. This would assist the professionals to identify the patient who was risk for unable to return-to-work and provide support for AMI patents.
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Qiao et al. (2024) conducted a systematic review in Acute myocardial infarction (AMI). Clinical and demographic factors (e.g., diabetes, heart failure, manual labor, depression) vs. Absence of respective factors was evaluated on Return-to-work (diabetes as a predictor) (OR 0.65, 95% CI 0.46-0.93). In a meta-analysis of 19 studies, the pooled return-to-work rate post-AMI was 74% at 3 months, with diabetes (OR 0.65) and heart failure (OR 0.43) acting as significant negative predictors.
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