Changes in social support within the early recovery period and outcomes after acute myocardial infarction.
OBJECTIVE
To examine changes in social support during early recovery after acute myocardial infarction (AMI) and determine whether these changes influence outcomes within the first year.


METHODS
Among 1951 AMI patients enrolled in a 19-center prospective study, we examined changes in social support between baseline (index hospitalization) and 1 month post-AMI to longitudinally assess their association with health status and depressive symptoms within the first year. We further examined whether 1-month support predicted outcomes independent of baseline support. Hierarchical repeated-measures regression evaluated associations, adjusting for site, baseline outcome level, baseline depressive symptoms, sociodemographic characteristics, and clinical factors.


RESULTS
During the first month of recovery, 5.6% of patients had persistently low support, 6.4% had worsened support, 8.1% had improved support, and 80.0% had persistently high support. In risk-adjusted analyses, patients with worsened support (vs. persistently high) had greater risk of angina (relative risk=1.46), lower disease-specific quality of life (β=7.44), lower general mental functioning (β=4.82), and more depressive symptoms (β=1.94) (all p≤.01). Conversely, patients with improved support (vs. persistently low) had better outcomes, including higher disease-specific quality of life (β=6.78), higher general mental functioning (β=4.09), and fewer depressive symptoms (β=1.48) (all p≤.002). In separate analyses, low support at 1 month was significantly associated with poorer outcomes, independent of baseline support level (all p≤.002).


CONCLUSIONS
Changes in social support during early AMI recovery were not uncommon and were important for predicting outcomes. Intervening on low support during early recovery may provide a means of improving outcomes.
Yale University School of Medicine, 2 Church Street South, New Haven, CT 06519, United States. erica.leifheit-limson@yale.edu
Erica C
EC
Leifheit-Limson
Kimberly J
KJ
Reid
Stanislav V
SV
Kasl
Haiqun
H
Lin
Donna M
DM
Buchanan
Philip G
PG
Jones
Pamela N
PN
Peterson
Susmita
S
Parashar
John A
JA
Spertus
Judith H
JH
Lichtman
D000328:Adult; D000368:Aged; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology* / Q000534:rehabilitation; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D012944:Social Support; D011795:Surveys and Questionnaires; D016896:Treatment Outcome