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

Kilpi, Fanny; Konttinen, Hanna; Silventoinen, Karri; Martikainen, Pekka

doi:10.1016/j.socscimed.2015.03.054

Cited by 70 publications

(77 citation statements)

References 42 publications

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“…10 In multiple studies looking at low perceived social support between patients married and unmarried following MI, it was found that the absence of a partner at baseline was a predictor for death, specifically in-hospital mortality, and recurrent MI during long-term follow-up. 17 Several factors may explain our discrepant findings in comparison with these prior results. First, our analyses likely had limited statistical power due to the modest cohort size and relatively short follow-up period post-MI.…”

Section: Following Logistic Regression and Cox Proportional Hazarcontrasting

confidence: 80%

“…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).…”

Section: Methodsmentioning

confidence: 99%

“…9,10,25 For instance, in a Finnish population, those living alone without a partner were at 30% to 50% higher odds for first-day fatality after hospitalization for MI compared with those who were married. 17 In an analysis of stable patients with CVD followed in the Reduction of Atherothrombosis for Contin- that the quality of a marital relationship was independently predictive of survival after HF. 5,27 In an attempt to highlight the importance of life stressors on CV health, Dupre et al identified that an individual's current marital status was not associated with the incidence of MI, but rather changes in marital status, such as an accumulated number of divorces, were strongly associated with risk for MI.…”

Section: Following Logistic Regression and Cox Proportional Hazarmentioning

confidence: 99%

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

Ghosh-Swaby

Tan

Bagai

et al. 2018

Clinical Cardiology

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While divorced or living alone, patients with stable cardiovascular disease are at increased risk for adverse cardiovascular events. The importance of marital status following a myocardial infarction (MI) is less clear. We hypothesized that marital status may affect cardiovascular outcomes following MI. We analyzed outcomes among patients with MI who underwent percutaneous coronary intervention from the Canadian Observational Antiplatelet Study (COAPT).Marital status was categorized into 3 groups: married/common-law patients living together; never married; and divorced, separated, or widowed patients. Patients were followed for 15 months and our primary outcome was the occurrence of a major adverse cardiovascular event (MACE), defined as a composite of mortality, repeat acute MI, stroke, or urgent coronary revascularization. Multivariable logistic regression models were performed, with married/common-law patients living together considered the reference group. Among 2100 patients included in analyses, 1519 (72.3%) were married/common-law patients living together, 358 (17.1%) were separated/divorced/widowed, and 223 (10.6%) patients were never married.Dual antiplatelet therapy use after 15 months was similar across groups (75.4%, 77.8%, and 73.6%, respectively). The risk of MACE after 15 months was similar among married patients living together (12.7%; referent) compared with patients who were never married (13.9%; adjusted odds ratio: 1.09, 95% confidence interval: 0.58-2.07, P = 0.79) and patients separated/divorced/widowed (14.3%; adjusted odds ratio: 0.71, 95% confidence interval: 0.40-1.25, P = 0.23). Similarly, the risk of individual endpoints, including mortality, was similar across the 3 groups. Among patients stabilized following an MI, we found no association between marital status and 15-month outcomes.

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Section: Following Logistic Regression and Cox Proportional Hazarcontrasting

confidence: 80%

Section: Methodsmentioning

confidence: 99%

Section: Following Logistic Regression and Cox Proportional Hazarmentioning

confidence: 99%

See 1 more Smart Citation

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

Ghosh-Swaby

Tan

Bagai

et al. 2018

Clinical Cardiology

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“…Living alone is a well-known health risk factor. [23][24][25][26] In addition, a previous study conducted in Japan showed that who people live with was important for increased risk of coronary heart disease incidence and mortality. 26 Thus, the magnitude of stroke risk could vary by living arrangement.…”

Section: Strokementioning

confidence: 99%

Marital Transition and Risk of Stroke

Honjo

Iso

Ikeda

et al. 2016

Stroke

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Background and Purpose-There have been consistent findings reported that marital transition (ie, change in marital status during a given time period) is associated with risk of cardiovascular disease; however, few studies have been conducted on stroke risk, particularly stroke subtypes. Moreover, no studies have examined the moderating effect of living arrangement and employment status on the association between marital transition and stroke risk. Methods-We examined sex-specific associations between marital transition and stroke risk using data from Japan Public Health Center-based Prospective Study. We included 24 162 men and 25 626 women who were married at prebaseline (5 years before baseline). Marital transition was determined by marital status at baseline. Weighted hazard ratios of stroke risk were estimated by Cox proportional regression analysis with inverse probability of weighting using a propensity score. Results-An increased risk of stroke, particularly hemorrhagic stroke, was observed among men and women with marital transition (ie, married to unmarried); weighted hazard ratios (95% confidence interval [CI]) for men and women were 1.26 (1.13-1.41) and 1.26 (1.09-1.45), respectively. Participants with marital transition and lived with children had increased stroke risk. Living with parents buffered the increased stroke risk owing to marital transition among men; however, no such effect was identified among women. Elevated stroke risk owing to marital transition was magnified among women if they were unemployed; weighted hazard ratio=2.98 (95% CI, 1.66-5.33). Conclusions-Living .).The online-only Data Supplement is available with this article at http://stroke.ahajournals.org/lookup/suppl

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“…With regard to this information, research has shown that unmarried individuals have fewer resources, less social support, less social control, more risk behaviours and worse health outcomes compared to married people (Dupre & Nelson, 2016). The study of this variable in subjects with CVD, especially in acute coronary syndrome (Jiang et al, 2013;Kilpi, Konttinen, Silventoinen, & Martikainen, 2015;Dupre & Nelson, 2016) shows that unmarried individuals are more susceptible to suffer cardiac events and are associated with higher mortality. Nevertheless, looking at gender differences, it appears that women always have increased risk of cardiac events than men whatever their marital status (Jiang et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Gender differences in a sample of people with heart disease

Pacheco

Alves

Santos

2017

mill

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RESUMOIntrodução: Não sendo as doenças cardiovasculares exclusivas do homem nem da mulher, importa conhecer que diferenças existem entre os géneros, uma vez que é um facto que as características físicas e psicossociais que os distinguem, podem influenciar os vários domínios da sua saúde, nomeadamente a saúde cardiovascular. Objetivos: Identificar diferenças de género numa amostra de pessoas com doença cardíaca. Métodos: Estudo quantitativo, transversal, que utiliza a análise descritiva e multivariada de dados com recurso à regressão logística. Conclusões: Os enfermeiros devem consciencializar-se de que as diferenças de género entre o homem e a mulher os fazem diferir no seu risco cardiovascular. Por tal, devem estar sensibilizados para a necessidade de identificar os fatores que o podem influenciar e definir e implementar intervenções capazes de reduzir esse risco para cada género. Palavras-chave: Género e Saúde; Doenças Cardiovasculares; Fatores de Risco ABSTRACTIntroduction: Cardiovascular diseases are not unique to either men or women, so that it is important to know what differences exist between the sexes, since it is a fact that the physical and psychosocial problems that distinguish them can influence the various areas of their health, particularly cardiovascular health. Objectives: To identify gender differences in a sample of people with heart disease. Methods: A quantitative, cross-sectional study with descriptive and multivariate data analysis using logistic regression. Conclusions: Nurses should be aware that gender differences between men and women make mean they differ in terms of cardiovascular risk. For this reason, they should be aware of the need to identify the factors that can influence the risk and define and implement interventions that reduce this risk for each gender.

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

Cited by 70 publications

References 42 publications

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

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

Marital Transition and Risk of Stroke

Gender differences in a sample of people with heart disease

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