title: Effect of low perceived social support on health outcomes in young patients with acute myocardial infarction: results from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study.
abstract: BACKGROUND
  Social support is an important predictor of health outcomes after acute myocardial infarction (AMI), but social support varies by sex and age. Differences in social support could account for sex differences in outcomes of young patients with AMI.
  
  
  RESULTS
  Data from the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study, an observational study of AMI patients aged ≤55 years in the United States and Spain, were used for this study. Patients were categorized as having low versus moderate/high perceived social support using the ENRICHD Social Support Inventory. Outcomes included health status (Short Form-12 physical and mental component scores), depressive symptoms (Patient Health Questionnaire), and angina-related quality of life (Seattle Angina Questionnaire) evaluated at baseline and 12 months. Among 3432 patients, 21.2% were classified as having low social support. Men and women had comparable levels of social support at baseline. On average, patients with low social support reported lower functional status and quality of life and more depressive symptoms at baseline and 12 months post-AMI. After multivariable adjustment, including baseline health status, low social support was associated with lower mental functioning, lower quality of life, and more depressive symptoms at 12 months (all P<0.001). The relationship between low social support and worse physical functioning was nonsignificant after adjustment (P=0.6). No interactions were observed between social support, sex, or country.
  
  
  CONCLUSIONS
  Lower social support is associated with worse health status and more depressive symptoms 12 months after AMI in both young men and women. Sex did not modify the effect of social support.
authors.affiliation: Yale University School of Medicine, New Haven, CT (E.M.B.) Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT (E.M.B., J.H.L.).
authors.forename: Emily M
authors.initials: EM
authors.lastname: Bucholz
authors.affiliation: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (K.M.S., R.P.D., M.G., E.S.S., H.M.K.).
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Strait
authors.affiliation: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (K.M.S., R.P.D., M.G., E.S.S., H.M.K.).
authors.forename: Rachel P
authors.initials: RP
authors.lastname: Dreyer
authors.affiliation: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (K.M.S., R.P.D., M.G., E.S.S., H.M.K.).
authors.forename: Mary
authors.initials: M
authors.lastname: Geda
authors.affiliation: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (K.M.S., R.P.D., M.G., E.S.S., H.M.K.) Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, Madrid, Spain (E.S.S., H.M.K.).
authors.forename: Erica S
authors.initials: ES
authors.lastname: Spatz
authors.affiliation: Department of Cardiology, Hospital General Universitario "Gregario Maraon", Madrid, Spain (H.B.).
authors.forename: Hector
authors.initials: H
authors.lastname: Bueno
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT (E.M.B., J.H.L.).
authors.forename: Judith H
authors.initials: JH
authors.lastname: Lichtman
authors.affiliation: Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT (G.O.).
authors.forename: Gail
authors.initials: G
authors.lastname: D'Onofrio
authors.affiliation: Mid-America Heart Institute, University of Missouri-Kansas City Kansas City, MO (J.A.S.).
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program, Departments of Internal Medicine and Health Policy and Management, Yale School of Public Health, New Haven, CT (H.M.K.) Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (K.M.S., R.P.D., M.G., E.S.S., H.M.K.) Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, Madrid, Spain (E.S.S., H.M.K.).
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
mesh_terms: D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D063868:Patient Outcome Assessment; D010465:Perception; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors; D018434:Sickness Impact Profile; D012944:Social Support; D018709:Statistics, Nonparametric
keywords: myocardial infarction; prognosis; sex