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Emotional Support and Survival after Myocardial Infarction: A Prospective, Population-based Study of the Elderly

Lisa F. Berkman, PhD; Linda Leo-Summers, MPH; and Ralph I. Horwitz, MD
[+] Article, Author, and Disclosure Information

Grant Support: In part by the Robert Wood Johnson Foundation (grant 9923) and the National Institute on Aging (contract N01-AG-02105).

Requests for Reprints: Lisa F. Berkman, PhD, Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, New Haven, CT 06510.

Current Author Addresses: Dr. Berkman and Ms. Leo-Summers: Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, New Haven, CT 06510.

Dr. Horwitz: Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, P.O. Box 3333, New Haven, CT 06510.

© 1992 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1992;117(12):1003-1009. doi:10.7326/0003-4819-117-12-1003
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Objective: To compare the survival of elderly patients hospitalized for acute myocardial infarction who have emotional support with that of patients who lack such support, while controlling for severity of disease, comorbidity, and functional status.

Design: A prospective, community-based cohort study.

Setting: Two hospitals in New Haven, Connecticut.

Patients: Men (n = 100) and women (n = 94) 65 years of age or more hospitalized for acute myocardial infarction between 1982 and 1988.

Measurements: Social support, age, gender, race, education, marital status, living arrangements, presence of depression, smoking history, weight, and physical function were assessed prospectively using questionnaires. The presence of congestive heart failure, pulmonary edema, and cardiogenic shock; the position of infarction; in-hospital complications; and history of myocardial infarction were assessed using medical records. Comorbidity was defined using an index based on the presence of eight conditions.

Results: Of 194 patients, 76 (39%) died in the first 6 months after myocardial infarction. In multiple logistic regression analyses, lack of emotional support was significantly associated with 6-month mortality (odds ratio, 2.9; 95% Cl, 1.2 to 6.9) after controlling for severity of myocardial infarction, comorbidity, risk factors such as smoking and hypertension, and sociodemographic factors.

Conclusions: When emotional support was assessed before myocardial infarction, it was independently related to risk for death in the subsequent 6 months.





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