Psychosocial Influences on Mortality after Myocardial Infarction

TLDR

Psychosocial interviews of 2,320 male myocardial infarction survivors in the β‑Blocker Heart Attack Trial defined two variables strongly linked to higher three‑year mortality. Men who were socially isolated and highly stressed had more than four times the risk of death, a risk that was stronger among less educated men and applied to both total and sudden cardiac deaths regardless of ventricular ectopy. Published in N Engl J Med 1984; 311:552–9.

Abstract

Psychosocial interviews with 2320 male survivors of acute myocardial infarction, participants in the β-Blocker Heart Attack Trial, permitted the definition of two variables strongly associated with an increased three-year mortality risk. With other important prognostic factors controlled for, the patients classified as being socially isolated and having a high degree of life stress had more than four times the risk of death of the men with low levels of both stress and isolation. An inverse association of education with mortality in this population reflected the gradient in the prevalence of the defined psychosocial characteristics. High levels of stress and social isolation were most prevalent among the least-educated men and least prevalent among the best-educated. The increase in risk associated with stress and social isolation applied both to total deaths and to sudden cardiac deaths and was noted among men with both high and low levels of ventricular ectopy during hospitalization for the acute infarction. (N Engl J Med 1984; 311:552–9.)