Marital status, depressive episodes, and short-term prognosis of patients with acute coronary syndrome: Greek study of acute coronary syndrome (GREECS)

The association between marital status and short-term prognosis of patients hospitalized for acute coronary syndrome (ACS) was evaluated. From October 2003 to September 2004, a sample of 6 hospitals located in Greek regions was selected, and almost all survivors after an ACS were enrolled into the study (2172 patients were included in the study; 76% were men). The in-hospital mortality rate was 3.2% in male patients and 5.7% in female patients (p = 0.009). Never-married patients had 2.8-times higher risk of dying during hospitalization compared with married, after adjusting for various confounders (p < 0.01, attributable risk = 64%). Furthermore, never-married had 2.7-times higher risk of dying during the first 30-days following hospitalization compared with married (p < 0.01, attributable risk = 62%). Moderate depressive symptoms 3.26-fold (95% CI 1.40–7.11) the risk of recurrent events, while severe depressive symptoms were associated with 8.2-fold (95% CI 3.98–17.1) higher risk of events. No interaction was observed between marital status and depression on 30-day prognosis of ACS patients (p > 0.5). People who were not-married and depressed at the time of an acute cardiac episode were at higher risk of fatal events than people who were married, irrespective of depression status and other characteristics.