Changes in social support within the early recovery period and outcomes after acute myocardial infarction
Journal of Psychosomatic Research, 05/17/2012
Leifheit-Limson EC et al. - Changes in social support during early acute myocardial infarction (AMI) recovery were not uncommon and were important for predicting outcomes. Intervening on low support during early recovery may provide a means of improving outcomes.
Among 1951 AMI patients enrolled in a 19-center prospective study, the authors examined changes in social support between baseline (index hospitalization) and 1month post-AMI to longitudinally assess their association with health status and depressive symptoms within the first year.
The authors further examined whether 1-month support predicted outcomes independent of baseline support.
Hierarchical repeated-measures regression evaluated associations, adjusting for site, baseline outcome level, baseline depressive symptoms, sociodemographic characteristics, and clinical factors.
During the first month of recovery, 5.6% of patients had persistently low support, 6.4% had worsened support, 8.1% had improved support, and 80.0% had persistently high support.
In risk-adjusted analyses, patients with worsened support (vs. persistently high) had greater risk of angina (relative risk=1.46), lower disease-specific quality of life (β=7.44), lower general mental functioning (β=4.82), and more depressive symptoms (β=1.94) (all p≤.01).
Conversely, patients with improved support (vs. persistently low) had better outcomes, including higher disease-specific quality of life (β=6.78), higher general mental functioning (β=4.09), and fewer depressive symptoms (β=1.48) (all p≤.002).
In separate analyses, low support at 1month was significantly associated with poorer outcomes, independent of baseline support level (all p ≤.002).
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