title: Living alone, patient sex and mortality after acute myocardial infarction.
abstract: BACKGROUND
  Psychosocial factors, including social support, affect outcomes of cardiovascular disease, but can be difficult to measure. Whether these factors have different effects on mortality post-acute myocardial infarction (AMI) in men and women is not clear.
  
  
  OBJECTIVE
  To examine the association between living alone, a proxy for social support, and mortality postdischarge AMI and to explore whether this association is modified by patient sex.
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  All patients discharged with a primary diagnosis of AMI in a major urban center during the 1998-1999 fiscal year.
  
  
  METHODS
  Patients' sociodemographic and clinical characteristics were obtained by standardized chart review and linked to vital statistics data through December 2001.
  
  
  RESULTS
  Of 880 patients, 164 (18.6%) were living alone at admission and they were significantly more likely to be older and female than those living with others. Living alone was independently associated with mortality [adjusted hazard ratio (HR) 1.6, 95% confidence interval (CI) 1.0-2.5], but interacted with patient sex. Men living alone had the highest mortality risk (adjusted HR 2.0, 95% CI 1.1-3.7), followed by women living alone (adjusted HR 1.2, 95% CI 0.7-2.2), men living with others (reference, HR 1.0), and women living with others (adjusted HR 0.9, 95% CI 0.5-1.5).
  
  
  CONCLUSIONS
  Living alone, an easily measured psychosocial factor, is associated with significantly increased longer-term mortality for men following AMI. Further prospective studies are needed to confirm the usefulness of living alone as a prognostic factor and to identify the potentially modifiable mechanisms underlying this increased risk.
authors: Department of Medicine, University of Calgary, Calgary, AB, Canada.
authors: Heidi N
authors: HN
authors: Schmaltz
authors: Danielle
authors: D
authors: Southern
authors: William A
authors: WA
authors: Ghali
authors: Susan E
authors: SE
authors: Jelinski
authors: Gerry A
authors: GA
authors: Parsons
authors: Kathryn M
authors: KM
authors: King
authors: Colleen J
authors: CJ
authors: Maxwell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality*; D010351:Patient Discharge / Q000639:trends; D012111:Residence Characteristics; D012737:Sex Factors; D013997:Time Factors