Abstract 12064: Living with Significant Other is Associated with Lower Risk for Emergency Readmission after Unstable Angina&Non-ST Elevation Myocardial Infarction
Introduction: Patients who are diagnosed with unstable angina (UA) or non-ST elevation myocardial infarction (non-STEMI) are at risk for repeated acute cardiac episodes resulting in emergent rehospitalization. American Heart Association/American College of Cardiology practice guidelines recommend use of risk stratification prior to hospital discharge; however, the importance of identifying patients’ social support for follow-up planning is not emphasized.
Hypothesis: UA and non-STEMI patients who live with significant others are less likely to return to the Emergency Department (ED) for acute cardiac-related events within one year.
Methods: Secondary analysis was conducted of data from a prospective clinical trial (IMMEDIATE AIM Study, RO1HL69753), in which patients presenting to the ED with chest pain were enrolled and followed for one year. A total of 166 patients with UA or non-STEMI and 1-year outcome data were included in the present analysis. Hazard over time analyses were performed to assess whether living with a significant other was associated with cardiac-related ED readmission during the follow-up period. Significant other was defined as spouse, partner, child, or other care provider.
Results: Multivariate Cox Regression analyses controlling for gender, race, discharge diagnosis, and Thrombolysis in Myocardial Infarction (TIMI) risk score revealed that patients who lived with a significant other were less likely to return to the ED for an acute cardiac event within one follow-up year. Living with a significant other was a significant independent contributor to the statistical model (hazard ratio =.47, 95% confidence interval .29 - .75, p=.002). Overall sensitivity and specificity of the model was 73% (C-statistic=.73).
Conclusions: In patients with UA or non-STEMI, living without a significant other confers a 2 times greater relative risk of ED cardiac-related readmittance compared with patients who live with a significant other. Prospective clinical trials are needed to identify what the beneficial “active ingredients” are in living with a significant other and to develop interventions to reduce risk for patients who do not have a significant other living arrangement.
- © 2012 by American Heart Association, Inc.