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The Prognostic Effect of Physical Health Complaints With New Cardiac Events and Mortality in Patients With a Myocardial Infarction

Van Beek, M. H. C. T., Roest, A. M., Wardenaar, K. J., Van Balkom, A. J. L. M., Speckens, A. E. M., Voshaar, R. C. O. & Zuidersma, M., Mar-2017, In : Psychosomatics. 58, 2, p. 121-131 11 p.

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  • The Prognostic Effect of Physical Health Complaints With New Cardiac Events

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Background: 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. Objective: To evaluate the effect of physical health complaints post-MI on cardiac prognosis adjusting for cardiac disease severity, depression, and anxiety. Methods: 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 ML left ventricular ejection fraction, depressive symptoms, and generalized anxiety disorder. Results: 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) nol 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 [1.112.16]2.16], HRmixed 1.71 [1.19-2.47], and HRenergy = 1.51 [1.09-2.08]). Conclusions: 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.

Original languageEnglish
Pages (from-to)121-131
Number of pages11
JournalPsychosomatics
Volume58
Issue number2
Early online date5-Nov-2016
Publication statusPublished - Mar-2017

    Keywords

  • myocardial infarction, energy complaints, cardiac complaints, sleep complaints, cardiovascular prognosis, depression, anxiety, physical health, QUALITY-OF-LIFE, CORONARY-HEART-DISEASE, SELF-RATED HEALTH, FOLLOW-UP, CARDIOVASCULAR EVENTS, DEPRESSIVE SYMPTOMS, HIGH-RISK, ASSOCIATION, ANXIETY, FAILURE

ID: 39654607