Marital Status and Outcome of Patients Presenting with Acute Coronary Syndrome: An Observational Report

Abstract

Background & hypothesis:Data on the clinical characteristics and outcome of patients presenting with acute coronary syndrome (ACS) according to their marital status is not clear.Methods:A total of 5334 patients presenting with ACS in 65 hospitals in 6 Middle East countries in the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE‐2) were studied according to their marital status (5024 married, 100 single, and 210 widowed patients).Result:When compared to married patients, widowed patients were older and more likely to be female. Widowed patients were more likely to have diabetes mellitus, hypertension, history of heart failure, and peripheral vascular disease and were less likely to be tobacco users when compared to the other groups. Widowed patients were also more likely to present with atypical symptoms and have advanced Killip class. Widowed patients were more likely to present with non‐ST‐elevation myocardial infarction (NSTEMI) when compared to the other 2 groups. Widowed patients were more likely to have heart failure (P = 0.001), cardiogenic shock (P = 0.001), and major bleeding (P = 0.002) when compared to the other groups. No statistically significant difference was observed in regard to duration of hospital stay, door to needle time in STEMI patients, or cardiac arrhythmias between the various groups. Widowed patients had higher in‐hospital, 30‐day, and 1‐year mortality rates (P = 0.001). Marital status was an independent predictor for in‐hospital mortality.Conclusion:Widowed marital status was associated with worse cardiovascular risk profile, and worse in‐hospital and 1‐year outcome. Future work should be focused on whether the provision of psychosocial support will result in improved outcomes among this high‐risk group. Clin. Cardiol. 2011 DOI: 10.1002/clc.22034Gulf RACE is a Gulf Heart Association (GHA) project and was financially supported by the GHA, Sanofi Aventis, and the College of Medicine Research Center at King Khalid University Hospital, King Saud University, and Riyadh, Saudi Arabia.The authors have no other funding, financial relationships, or conflicts of interest to disclose.

High Blood Pressure Prevalence, Awareness, Control, and Associated Factors in a Low-Resource African Setting

“…This association could be explained by the influence of age, assuming that widows are commonly older than marrieds, whom are commonly older than singles. Marital status has previously shown association with hypertension (24, 27, 28), being married affecting lifestyle, health-related behaviors, psychosocial support and adherence to dietary advice, and medical treatment (24, 29). However, level and direction of the effect differ from a study to another, being sometimes conflicting.…”

The effects of Ramadan fasting on heart rate variability in healthy individuals: A prospective study

“…HRV was increased in healthy individuals with Ramadan fasting, as evidenced by increased SDNNI, pNN50 and RMSSD parameters evaluated from the entire recording. Support provided by marriage, religiosity or faith, and other forms of social connection have been associated with activation of the PNS and have decreased the risk of future cardiovascular events (31,32). Vagal activity is the major contributor to the HF component.…”

Marital Status and Outcomes in Patients With Cardiovascular Disease

“…In contrast, evidence for increased risk of adverse cardiovascular outcomes in unmarried populations remains conflicting . Although survival according to marital status has been reported in patients presenting with acute coronary syndromes, few studies have evaluated the relationship between adverse cardiovascular outcomes and marital status in patients with known or suspected coronary artery disease (CAD) . In addition, the definition of unmarried status is not always clear despite noted differences in the divorced or separated, widowed, and never‐married groups .…”