American Journal of Epidemiology Vol. 128, No. 4: 786-795
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
PROGNOSTIC IMPORTANCE OF SOMATIC AND PSYCHOSOCIAL VARIABLES AFTER A FIRST MYOCARDIAL INFARCTION
1 Department of Medicine, Ostra Hospital, Gothenburg University S-416 85 Gothenburg, Sweden
2 Department of Mathematics, Gothenburg University Gothenburg, Sweden
3 Department of Rehabilitation Medicine, Sahlgrenaka Hospital, Gothenburg University Gothenburg, Sweden
Send reprint requests to Dr. Ingela Wiklund at this address
The prognostic importance of somatic and psychosocial variables after a first myocardial infarction was studied in 201 consecutive Gothenburg, Sweden men below 61 years of age who had survived a first myocardial infarction between December 1976 and December 1978. The maximum follow-up time was 100 months. The prognostic importance of somatic, social, and psychological variables was related to the endpoints of death, nonfatal reinfarction, and total events. During follow-up, 48 deaths and 37 nonfatal recurrences occurred. Four variables, none of them significantly correlated with each other, were related to risk of an endpoint. Being single increased risk of death (p < 0.01) and risk of all events (p < 0.001), whereas an index reflecting infarct size was correlated to risk of death (p<0.001). A prognostic index based upon data available at three months after the myocardial infarction (angina pectoris, hypertension, serum aspartate aminotransferase (S-ASAT) maximum, and smoking) was correlated to risk of nonfatal reinfarction (p < 0.05). Use of sedatives was also related to risk of reinfarction (p<0.05) and to risk of total event (p<0.05). The probability of death, reinfarction, and total event was estimated within two and five years after the infarction for all combinations of the variables that were related to risk of an endpoint. It was thus demonstrated that the predictive power increased over time and that the somatic and psychosocial variables independently added information.
mortality; myocardial Infarction; prognosis; psychology
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  H. S. Lett, J. A. Blumenthal, M. A. Babyak, T. J. Strauman, C. Robins, and A. Sherwood Social Support and Coronary Heart Disease: Epidemiologic Evidence and Implications for Treatment Psychosom Med, November 1, 2005; 67(6): 869 - 878. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Rozanski, J. A. Blumenthal, and J. Kaplan Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy Circulation, April 27, 1999; 99(16): 2192 - 2217. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. M. Glynn, N. Christenfeld, and W. Gerin Gender, Social Support, and Cardiovascular Responses to Stress Psychosom Med, March 1, 1999; 61(2): 234 - 242. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. P. Wray, J. C. Hollingsworth, N. J. Petersen, and C. M. Ashton Case-Mix Adjustment Using Administrative Databases: A Paradigm to Guide Future Research Med Care Res Rev, September 1, 1997; 54(3): 326 - 356. [Abstract] [PDF]
|
|
|
|
 |
|
 P.-O. Ostergren, M. Freitag, B. s Hanson, E. Hedin, S.-O. Isacsson, H. Odeberg, and S.-E. Svensson Social network and social support predict improvement of physical working capacity in rehabilitation of patients with first myocardial infarction Scand J Public Health, December 1, 1991; 19(4): 225 - 234. [Abstract] [PDF]
|
|