Perceived social support at different times after myocardial infarction and long-term mortality risk: a prospective cohort study.
Previous research has explored the association between social support (SS), cardiovascular disease, and mortality. Perceived SS (PSS) refers to an individual's attitude toward received SS. This study aimed to: (1) assess the association between PSS levels and long-term mortality among first myocardial infarction (MI) survivors, (2) compare the effect of PSS measured shortly after the first MI to PSS measured 10-13 years after MI, and (3) compare the prognostic role of different PSS components: family, friends, and significant others.



Patients were drawn from the longitudinal prospective Israel Study of First Acute Myocardial Infarction (ISFAMI). PSS, sociodemographic and health variables were assessed in two subcohorts during initial hospitalization from 1992 to 1993 (T1, n = 660) and in 2002-2005 (T2, n = 969). Vital status was determined through 2011. Cox regression models assessed mortality risk associated with PSS.



By the end of follow-up, 212 (32%) of the T1 and 229 (24%) of T2 subcohorts had died. Higher PSS levels were associated with lower mortality risk at both T1 and T2 (per one standard deviation [1SD] increase hazard ratio [HR] = 0.85, 95% confidence interval [CI] = 0.75-0.96; HR = 0.74, 95% CI = 0.66-0.83, respectively). These associations were attenuated on adjustment for sociodemographic and clinical variables (HR = 0.93, 95% CI = 0.80-1.07; HR = 0.88, 95% CI = 0.77-1.00, respectively). PSS from friends was significantly associated with lower mortality risk at both T1 and T2 and remained significant only at T2 after adjustment (HR = 0.85, 95% CI = 0.73-0.98).



Higher PSS levels were significantly associated with reduced mortality risk post-MI. This should encourage clinicians to assess post-MI psychosocial status to identify high-risk patients.
Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel.
Netanela
N
Weiss-Faratci
Kfar Saba Adult Clinic, Shalvata Mental Health Center, Hod Hasharon, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: ido.lurie@gmail.com.
Ido
I
Lurie
Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel.
Yehuda
Y
Neumark
Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel.
Maureen
M
Malowany
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Gali
G
Cohen
Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.
Yael
Y
Benyamini
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Uri
U
Goldbourt
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Yariv
Y
Gerber
D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007557:Israel; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology*; D010465:Perception; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012944:Social Support; D016019:Survival Analysis
Epidemiology; Mortality; Myocardial infarction; Perceived social support; Secondary prevention