Long-term prognostic significance of living alone and other risk factors in patients with acute myocardial infarction
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Living alone has been associated with higher risk of acute coronary syndrome in general population, but there are no consistent findings about its effect on prognosis after acute myocardial infarction (AMI).
To analyse the relationships between living alone and other risk factors at baseline and long-term survival after AMI.
One hundred and thirty-five patients with confirmed myocardial infarction (MI) admitted to the coronary care unit of the Institute of Cardiovascular Diseases, Clinical Centre of Serbia in Belgrade, between June 2002 and April 2006, were followed up until September 2011. Survival time was estimated using the Kaplan–Meier method and Cox regression analysis.
Patients with MI were followed up for a median of 77 months. The mean age of participants was 57.82 years (SD ± 10.8), and one quarter of them were women. According to the multivariate Cox regression analysis stratified on marital status, the model in which were included living alone, age, gender, education, obesity, smoking, hyperlipidaemia, hypertension, diabetes mellitus, previous cardiovascular and other disease, thrombolytic therapy and localisation of MI, the following variables were found to be independent predictors of death after AMI: living alone, with a hazard ratio (HR) of 7.60 [95 % confidence interval (CI) 1.99–29.08], diabetes mellitus (HR 3.31; 95 % CI 1.33–8.23), current smoking (HR 2.82; 95 % CI 1.03–7.71) and, older age (HR 1.13; 95 % CI 1.06–1.19).
The results of this study support hypothesis that patients who live alone have higher long-term all-cause mortality following AMI.
KeywordsMyocardial infarction Living alone Cardiovascular risk factors Prognosis Survival analysis Risk factor analysis
This work was supported by the Ministry for Science and Technology of the Republic of Serbia, through contract number 175042 (2011–2014).
Conflict of interest
Dr. Vujcic has nothing to disclose.
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