Association between living alone and all-cause mortality of young and middle-aged patients with acute myocardial infarction: analysis of the China Acute Myocardial Infarction (CAMI) registry

Abstract

Abstract Background: Lack of social support is a known predictor of the prognosis after acute myocardial infarction (AMI). Although as a common factor associated with social support, there are limited data on long-term prognostic impact of living status in young and middle-aged patients with AMI. Methods and Results: We analyzed data from the China Acute Myocardial Infarction (CAMI) Registry, a total of 8307 consecutive AMI young and middle-aged patients admitted at 108 hospitals in China between January 2013 and September 2014 were included. The primary endpoint was 2-year all-cause mortality. The secondary endpoints included in-hospital mortality and 2-year major adverse cardiac and cerebrovascular events (MACCEs; a composite of all-cause mortality, MI, or stroke). Multivariate logistic regression analysis and Cox proportional hazard models were used to evaluate the effect of living status on short-term and long-term outcomes. Of the analyzed patients, living alone was associated with 2-year all-cause mortality and MACCEs among all analyzed patients after multivariate adjustment (adjusted hazard ratio [HR] =2.082 [1.192-3.636], P=0.010; adjusted HR =2.130 [1.387-3.269], P=0.001), but not with poorer in-hospital mortality. Conclusions: The analysis suggested that living alone was associated with both 2-year all-cause mortality and MACCEs in AMI young and middle-aged patients but did not show an extra effect on the in-hospital mortality after covariate adjustment. Registration: NCT01874691 at https://www.clinicaltrials.gov/