title: Living alone and risk of cardiovascular events following discharge after acute myocardial infarction in Japan.
abstract: BACKGROUND
  Little is known about the long-term risk of cardiovascular events after discharge among acute myocardial infarction (AMI) survivors living alone in Japan.
  
  
  RESULTS
  A large-scale prospective, observational study in the Osaka region involved consecutive patients with AMI from January 2002 through December 2010. We evaluated the association between living alone and longitudinal risk of cardiovascular events following discharge after AMI. A Cox proportional-hazards model was used to assess the association between living alone and the primary composite endpoint consisting of major adverse cardiovascular events and total deaths. During the study period, 5845 patients (4415 male patients, 1430 female patients) were registered. Living alone was found to be independently associated with a higher risk of composite endpoint consisting of major adverse cardiovascular events and total deaths [adjusted hazard ratio (HR) 1.32; 95% confidence interval (CI): 1.11-1.58]. Multivariate-adjusted HRs of composite endpoint were 1.34 (95% CI: 1.08-1.68) among male patients and 1.31 (95% CI: 0.95-1.81) in the female patients. AMI survivors living alone tend to have a higher adjusted HR of composite endpoint than those not living alone irrespective of age and gender groups.
  
  
  CONCLUSIONS
  From this large AMI registry in Osaka, AMI survivors living alone after discharge had a higher risk of cardiovascular events and total deaths than those not living alone.
authors.affiliation: Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan.
authors.forename: Tetsuhisa
authors.initials: T
authors.lastname: Kitamura
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sakata
authors.forename: Daisaku
authors.initials: D
authors.lastname: Nakatani
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Suna
authors.forename: Masaya
authors.initials: M
authors.lastname: Usami
authors.forename: Sen
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hara
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Hamasaki
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nanto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sato
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012306:Risk; D012847:Single Person / Q000706:statistics & numerical data*; D012934:Social Isolation; D017741:Survivors / Q000706:statistics & numerical data*
keywords: Acute myocardial infarction; Cardiovascular events and total deaths; Living alone