Prognosis of acute coronary events is worse in patients living alone: the FINAMI myocardial infarction register

Abstract

Single living and/or being unmarried increases the risk of having a heart attack and worsens its prognosis both in men and women regardless of age. Most of the excess mortality appears already before the hospital admission and seems not to be related to differences in treatment of ACS.

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

“…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). Living alone can dispose to a particularly strong risk for mortality, because it may translate to severe and potentially fatal delays to obtaining acute care (Lammintausta et al, 2014;Schmaltz et al, 2007).…”

“…Another possible explanation is the relatively good socioeconomic status of women living alone. The association between living arrangements and MI incidence has also been found mainly in men (Gerward et al, 2010;Koskenvuo et al, 1981;Lammintausta et al, 2014;Nielsen et al, 2006). In the context of MI fatality, there is some evidence that living alone is particularly harmful for men (Schmaltz et al, 2007), but results from studies are inconsistent (Lammintausta et al, 2014).…”

“…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). Living alone can dispose to a particularly strong risk for mortality, because it may translate to severe and potentially fatal delays to obtaining acute care (Lammintausta et al, 2014;Schmaltz et al, 2007). Support from a partner is also likely to be highly important after experiencing an MI, considering the stress associated with the acute event and the heightened risk from depression (Frasure-Smith et al, 2000).…”

“…Jaffe et al, 2007;Kaplan and Kronick, 2006;Koskinen et al, 2007;Lillard and Waite, 1995;Martikainen et al, 2005;Rendall et al, 2011). Living with a marital partner is associated with a reduced risk of fatality after myocardial infarction (MI), the often fatal acute manifestation of CHD (Chandra et al, 1983;Gerward et al, 2010;Koskenvuo et al, 1981;Lammintausta et al, 2014), but few studies have been able to simultaneously examine the effect of living arrangements on both the incidence of MI and its subsequent survival. Therefore less is known about whether living arrangements are related similarly with the different stages of morbidity and mortality.…”

Association Between Recurrence of Urinary Calculi and Childbirth: A Population-Based Case-Control Study

“…Although unfavorable marital stress was associated with 3-fold increased risk of recurrent cardiovascular disease, 35 unmarried status may also intensify the risk of cardiovascular disease and metabolic syndrome. 36 Overall, women in high-quality marriages are known to have a lower risk of metabolic syndrome. 37 Interestingly, UC is associated with systemic metabolic and cardiovascular disorder.…”