Higher levels of perceived social support were associated with improved outcomes for AMI patients without elevated depression, with 24% of the overall cohort experiencing death or nonfatal AMI.
RCT (n=2,481)
Does higher perceived social support improve time to death or nonfatal reinfarction in patients recovering from AMI with increased psychosocial risk?
Higher perceived social support is associated with improved survival and reduced reinfarction in post-MI patients without elevated depression, highlighting the need for multidimensional psychosocial assessment.
OBJECTIVE: To compare the impact of network support and different types of perceived functional support on all-cause mortality or nonfatal reinfarction for patients with a recent acute myocardial infarction (AMI). DESIGN: Participants were recruited from the Enhancing Recovery in Coronary Heart Disease (ENRICHD) trial; 2,481 AMI patients with depression or low social support were randomized to a cognitive-behavioral intervention or to a usual care control group. Data collection for certain measures of social support was limited: 2,466 participants completed the ENRICHD Social Support Inventory; 2,457 completed the Perceived Social Support Scale; 1,296 completed the Social Network Questionnaire; and 707 completed the Interpersonal Support and Evaluation List, Tangible Support subscale. Patients also completed the Beck Depression Inventory and were followed for up to 4.5 years. MAIN OUTCOME MEASURE: Time to death or nonfatal reinfarction. RESULTS: Over the follow-up period, 599 patients (24%) died or had a nonfatal AMI. Survival models controlling age, sex, race, socioeconomic status, smoking, antidepressant use, and a composite measure of increased risk revealed that higher levels of perceived social support were associated with improved outcome for patients without elevated depression but not for patients with high levels of depression. Neither perceived tangible support nor network support were associated with more frequent adverse events. CONCLUSION: AMI patients should be assessed for multiple dimensions of perceived functional support and depression to identify those at increased psychosocial risk who may benefit from treatment.
Lett et al. (Sun,) conducted a rct in Acute myocardial infarction (AMI) with depression or low social support (n=2,481). Cognitive-behavioral intervention vs. Usual care was evaluated on Time to death or nonfatal reinfarction. Higher levels of perceived social support were associated with improved outcomes for AMI patients without elevated depression, with 24% of the overall cohort experiencing death or nonfatal AMI.