Psychosocial Predictors of Death for Low-Risk Patients After a First Myocardial Infarction

In Brief PURPOSE: This study aimed to identify whether psychosocial variables predicted mortality 7 years after a first myocardial infarction among patients who did not undergo revascularization. METHODS: The study population consisted of 222 men aged 30 to 60 years who entered an inpatient rehabilitation program a mean of 7 weeks after a first myocardial infarction. Medical data were obtained from the patients and their physicians at entry to the rehabilitation center and 1 year later. Psychosocial and medical variables were obtained from the patient by questionnaires at entry 1 and 7 years later. Follow-up evaluation was 96% complete. Statistical analyses are reported using odds ratios (OR). RESULTS: The 7-year mortality rate was 10.4%; the reinfarction rate was 9%; the hospital readmission rate was 32.3%; and 39.2% of the patients underwent a subsequent revascularization procedure, either coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA). The most important psychosocial predictors for death at 7 years identified with logistic regression analyses were lack of partnership (OR, 3.46), anxiety (OR, 1.19), and depression (OR, 1.04). Medical predictors of 7-year mortality were severity of infarction (OR, 2.86) and the number of coronary risk factors (OR, 1.77). CONCLUSIONS: Survival in a group of low-risk male patients 7 years after a first myocardial infarction was predicted by the following psychological and social variables: lack of partnership, depression, and anxiety. Although it is unknown whether the risk of dying 7 years after an initial myocardial infarction can be reduced by therapeutic interventions, these data reinforce the importance of special attention for patients with these psychosocial characteristics. To assess whether psychosocial variables predicted mortality, 222 men aged 30 to 60 years were followed during 7 years after a first myocardial infarction. Psychosocial and medical variables were analyzed. The 7-year mortality rate was 10.4%. Survival was predicted independently by the following variables: lack of partnership, depression, and anxiety.