Effect of marriage on duration of chest pain associated with acute myocardial infarction before seeking care

Abstract

Background: Coronary artery disease is the most common cause of death in the Western world, and being married decreases the risk of death from cardiovascular causes. We aimed to determine whether marital status was a predictor of the duration of chest pain endured by patients with acute myocardial infarction before they sought care and whether the patient's sex modified the effect. Methods:We conducted a retrospective, population-based cohort analysis of patients with acute myocardial infarction admitted to 96 acute care hospitals in Ontario, Canada, from April 2004 to March 2005. We excluded patients who did not experience chest pain. Using multivariable regression analyses, we assessed marital status in relation to delayed presentation to hospital (more than six hours from onset of pain), both overall and strat ified by sex. In patients who reported the exact duration of chest pain, we assessed the effect of marital status on the delay in seeking care. Interpretation: Among men experiencing acute myocardial infarction with chest pain, being married was associated with significantly earlier presentation for care, a benefit that was not observed for married women. Earlier presentation for medical care appears to be one reason for the observed lower risk of cardiovascular death among married men, relative to their single counterparts. Results AbstractResearch

Perfil sócio-demográfico e clínico de uma coorte de pacientes encaminhados a uma Clinica de Dor

“…Pain intensity was higher and duration was longer for females, with values similar to those found by other studies 18,19 . Our study has shown a positive correlation between musculoskeletal pain and pain duration, in line with a study which shows that in addition to individual behavioral factors in face of chronic musculoskeletal pain, when pain tends to be more persistent or continuous, resolution prognosis becomes more limited or grim 15 . Specialties referring more patients to the Pain Clinic were oncology, neurosurgery, rheumatology and orthopedics.…”

“…Some studies believe that pain affecting middle-aged adults with 40 to 49 years of age may be associated to labor activities, since this is an economically active group 9,14 . Also with regard to inactivity, a recent study relating pain to opioids prescription has reported that the shorter the opioid prescription period, the shorter the time patients are absent from work 15 . With regard to pain and marital status, our study has shown that most patients were married, ratifying a study on chest pain where the authors have reported significantly early manifestation for care and shorter pain duration in married males with acute myocardial infarction associated to chest pain 16 .…”

Living arrangements as determinants of myocardial infarction incidence and survival: A prospective register study of over 300,000 Finnish men and women

“…Marital relationships can exert social control over lifestyles detrimental to health (Umberson, 1992), but also provide an important source of social support, which helps to promote healthier behaviours and increase mental wellbeing, contributing to better physical health (Ross et al, 1990). Instrumental support from a partner can also lead to better early detection and care of both early atherosclerosis and later of more complicated forms of CHD such as MI (Atzema et al, 2011). However, when CHD manifests as an acute heart attack, survival often critically depends on reaching hospital quickly, which is likely to be an important contributor to the greater risks of out-of-hospital CHD deaths observed in the unmarried (Empana et al, 2008;Lammintausta et al, 2014;Sorlie et al, 2004).…”

Marital status and outcomes after myocardial infarction: Observations from the Canadian Observational Antiplatelet Study (COAPT)

“…We elected to compare results with the married/common-law patients living together group based on prior data suggesting this group had the lowest adjusted CV risk. 4,9,10,[15][16][17][18][19][20] We grouped patients who were separated, divorced, or widowed based on publications suggesting that this group was often at a higher risk for CV events. 9,[19][20][21][22][23][24] The primary outcome of this analysis was MACE 4 at 15 months, defined as a composite of all-cause death, repeat MI, stroke, or urgent coronary revascularization (UCR).…”