The Prognostic Effect of Physical Health Complaints With New Cardiac Events and Mortality in Patients With a Myocardial Infarction.
Self-rated general health has been associated with worse outcome after a myocardial infarction (MI). Previously, however, concurrent depression or anxiety was not taken into account.



To evaluate the effect of physical health complaints post-MI on cardiac prognosis adjusting for cardiac disease severity, depression, and anxiety.



The somatic subscale of the Health Complaints Scale was administered to 424 patients with MI at 3 and 12 months post-MI. Types and trajectories of health complaints were identified with latent transition analysis. The prognostic effect of Health Complaints Scale sum-score at 3 months, and of types and trajectories of health complaints on combined end points (new cardiac events and mortality) was evaluated with Cox regression. Adjustments were made for age, sex, education level, living alone, history of MI, left ventricular ejection fraction, depressive symptoms, and generalized anxiety disorder.



Overall, 189 (44.9%) patients with MI had a cardiac event or died during a mean follow-up of 5.7 (3.1) years. In the fully adjusted model, Health Complaints Scale sum-score predicted outcome (hazard ratio [HR] = 1.02 [95% CI: 1.00-1.05]). Latent transition analysis distinguished 5 groups at 3 and 12 months characterized by (1) no/minimal complaints, (2) cardiac complaints, (3) lack of energy, (4) sleep problems, and (5) mixed health complaints, resulting in 25 transition classes. Patients with cardiac and energy complaints at 3 months (HRcardiac= 1.55 [1.15-2.10] and HRenergy= 1.35[1.00-1.81]) and those with new or persistent cardiac, energy, and mixed complaints over time had a worse prognosis (HRcardiac= 1.55 [1.11-2.16], HRmixed= 1.71 [1.19-2.47], and HRenergy= 1.51 [1.09-2.08]).



Physical health complaints are predictors of cardiac outcome independent from cardiac disease, depression, and anxiety. Type and trajectories of health complaints may have additional prognostic significance.
Department of Psychiatry, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands. Electronic address: Marleen.vanBeek@radboudumc.nl.
Maria H C T
MH
Van Beek
University Center for Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Annelieke M
AM
Roest
University Center for Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Klaas J
KJ
Wardenaar
Department of Psychiatry and EMGO+ Institute, VU University Medical Center, GGZinGeest, Amsterdam, The Netherlands.
Anton J L M
AJ
Van Balkom
Department of Psychiatry, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Anne E M
AE
Speckens
University Center for Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Richard C
RC
Oude Voshaar
University Center for Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Marij
M
Zuidersma
D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000523:psychology; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index
anxiety; cardiac complaints; cardiovascular prognosis; depression; energy complaints; myocardial infarction; physical health.; sleep complaints