The effect of low social support on short-term prognosis in patients following a first myocardial infarction

Authors

  • SUSANNE SCHMIDT PEDERSEN,

    Corresponding author
    1. Medical Psychology, Department of Psychology and Health, Tilburg University, The Netherlands
    2. Department of Cardiology, Thoraxcentre, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands
      Susanne Schmidt Pedersen, PhD, Medical Psychology, Department of Psychology and Health, Room P503a, Warandelaan 2, PO Box 90153, 5000 LE Tilburg, The Netherlands. Tel:+31 13 466 2503; fax:+31 13 466 2370; e-mail: s.s.pedersen@uvt.nl
    Search for more papers by this author
  • RON THEODOOR VAN DOMBURG,

    1. Department of Cardiology, Thoraxcentre, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands
    Search for more papers by this author
  • MOGENS LYTKEN LARSEN

    1. Department of Cardiology, Aarhus University Hospital, Denmark
    Search for more papers by this author

Susanne Schmidt Pedersen, PhD, Medical Psychology, Department of Psychology and Health, Room P503a, Warandelaan 2, PO Box 90153, 5000 LE Tilburg, The Netherlands. Tel:+31 13 466 2503; fax:+31 13 466 2370; e-mail: s.s.pedersen@uvt.nl

Abstract

The objectives of the current study were (1) to assess adjustment in patients following a first myocardial infarction (MI) at 9 months compared with 4–6 weeks post-MI, (2) to examine the availability of and satisfaction with social support over time, and (3) to determine separate baseline psychosocial predictors of recurrent cardiac events. A questionnaire assessing post-traumatic stress disorder, anxiety, depression, health complaints, and social support, was distributed to consecutive patients 4–6 weeks and 9 months post-MI. Prior to assessment at follow-up, 8 (7%) of 112 patients had dropped out, and two had died due to cardiac causes. Objective clinical measures were obtained from medical records. There was an improvement in somatic and cognitive symptoms at follow-up, but no change in symptoms of arousal, depression, and anxiety. Half of the patients were afraid of a recurrent MI. There was a significant decrease in social support between baseline and follow-up, and lower social support at baseline was associated with a 10% increased risk of recurrent cardiac events at follow-up (OR: 0.90; 95% CI: 0.84 to 0.97) adjusting for all other variables. Some patients still experienced difficulties with psychosocial adjustment 9 months post-MI despite a reduction in somatic and cognitive symptoms. Social support decreased over time, which may have serious prognostic implications; lower social support at baseline was an independent predictor of recurrent events at 9 months. An important step for future research will be to investigate how social support can be enhanced in patients at risk.

Ancillary