Key result
Unmarried status is linked to ~2-fold higher prevalence of out-of-hospital coronary death in acute coronary events.
Why the study?
Overall and gender-specific associations between marital status and out-of-hospital coronary death compared with patients surviving to hospital admission were not well established.
Is not being married associated with an increased risk of out-of-hospital coronary death during acute coronary events?
Cross-Sectional (n=378,883)
Yes
Is not being married associated with an increased risk of out-of-hospital coronary death during acute coronary events?
Answers are grounded in this paper and cite their sources.
Not being married is independently associated with a higher proportion of out-of-hospital coronary death during acute coronary events, with differing risk profiles between genders.
OBJECTIVES: To assess overall and gender-specific associations between marital status and out-of-hospital coronary death (OHCD) compared with patients surviving to hospital admission. DESIGN: A cross-sectional study based on linkage of administrative health databases. SETTING: Beijing, China. PARTICIPANTS: From 2007 to 2019, 378 883 patients with acute coronary event were identified in the Beijing Monitoring System for Cardiovascular Diseases, a validated city-wide registration system based on individual linkage of vital registration and hospital discharge data. OUTCOME MEASURES: OHCD was defined as coronary death occurring before admission. Multilevel modified Poisson regression models were used to calculate the prevalence ratios (PR) and 95% CIs. RESULTS: Among 378 883 acute coronary events, OHCD accounted for 33.8%, with a higher proportion in women compared with men (41.5% vs 28.7%, p<0.001). Not being married was associated with a higher proportion of OHCD in both genders, with a stronger association in women (PR 2.18, 95% CI 2.10 to 2.26) than in men (PR 1.97, 95% CI 1.91 to 2.02; p for interaction <0.001). The associations of OHCD with never being married (PR 1.98, 95% CI 1.88 to 2.08) and being divorced (PR 2.54, 95% CI 2.42 to 2.67) were stronger in men than in women (never married: PR 0.98, 95% CI 0.82 to 1.16; divorced: PR 1.47, 95% CI 1.34 to 1.61) (p for interaction <0.001 for both). Being widowed was associated with a higher proportion of OHCD in both genders, with a stronger association in women (PR 2.26, 95% CI 2.17 to 2.35) compared with men (PR 1.89, 95% CI 1.84 to 1.95) (p for interaction <0.001). CONCLUSIONS: Not being married was independently associated with a higher proportion of OHCD and the associations differed by gender. Our study may aid the development of gender-specific public health interventions in high-risk populations characterised by marital status to reduce OHCD burden.
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Deng et al. (2022) conducted a cross-sectional in Acute coronary events (n=378,883). Not being married vs. Being married was evaluated on Out-of-hospital coronary death (OHCD) (PR 2.04, 95% CI 1.98 to 2.10). Not being married was associated with a higher prevalence of out-of-hospital coronary death compared to being married among patients experiencing acute coronary events.
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