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Marital Status and Outcomes in Patients With Cardiovascular Disease

BACKGROUND: Being unmarried is associated with decreased survival in the general population. Whether married, divorced, separated, widowed, or never‐married status affects outcomes in patients with cardiovascular disease has not been well characterized. METHODS AND RESULTS: A prospective cohort (inc...

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Autores principales: Schultz, William M., Hayek, Salim S., Samman Tahhan, Ayman, Ko, Yi‐An, Sandesara, Pratik, Awad, Mosaab, Mohammed, Kareem H., Patel, Keyur, Yuan, Michael, Zheng, Shuai, Topel, Matthew L., Hartsfield, Joy, Bhimani, Ravila, Varghese, Tina, Kim, Jonathan H., Shaw, Leslee, Wilson, Peter, Vaccarino, Viola, Quyyumi, Arshed A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778993/
https://www.ncbi.nlm.nih.gov/pubmed/29263033
http://dx.doi.org/10.1161/JAHA.117.005890
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author Schultz, William M.
Hayek, Salim S.
Samman Tahhan, Ayman
Ko, Yi‐An
Sandesara, Pratik
Awad, Mosaab
Mohammed, Kareem H.
Patel, Keyur
Yuan, Michael
Zheng, Shuai
Topel, Matthew L.
Hartsfield, Joy
Bhimani, Ravila
Varghese, Tina
Kim, Jonathan H.
Shaw, Leslee
Wilson, Peter
Vaccarino, Viola
Quyyumi, Arshed A.
author_facet Schultz, William M.
Hayek, Salim S.
Samman Tahhan, Ayman
Ko, Yi‐An
Sandesara, Pratik
Awad, Mosaab
Mohammed, Kareem H.
Patel, Keyur
Yuan, Michael
Zheng, Shuai
Topel, Matthew L.
Hartsfield, Joy
Bhimani, Ravila
Varghese, Tina
Kim, Jonathan H.
Shaw, Leslee
Wilson, Peter
Vaccarino, Viola
Quyyumi, Arshed A.
author_sort Schultz, William M.
collection PubMed
description BACKGROUND: Being unmarried is associated with decreased survival in the general population. Whether married, divorced, separated, widowed, or never‐married status affects outcomes in patients with cardiovascular disease has not been well characterized. METHODS AND RESULTS: A prospective cohort (inception period 2003–2015) of 6051 patients (mean age 63 years, 64% male, 23% black) undergoing cardiac catheterization for suspected or confirmed coronary artery disease was followed for a median of 3.7 years (interquartile range: 1.7–6.7 years). Marital status was stratified as married (n=4088) versus unmarried (n=1963), which included those who were never married (n=451), divorced or separated (n=842), or widowed (n=670). The relationship between marital status and primary outcome of cardiovascular death and myocardial infarction was examined using Cox regression models adjusted for clinical characteristics. There were 1085 (18%) deaths from all causes, 688 (11%) cardiovascular‐related deaths, and 272 (4.5%) incident myocardial infarction events. Compared with married participants, being unmarried was associated with higher risk of all‐cause mortality (hazard ratio [HR]: 1.24; 95% confidence interval [CI], 1.06–1.47), cardiovascular death (HR: 1.45; 95% CI, 1.18–1.78), and cardiovascular death or myocardial infarction (HR: 1.52; 95% CI, 1.27–1.83). Compared with married participants, the increase in cardiovascular death or myocardial infarction was similar for the participants who were divorced or separated (HR: 1.41; 95% CI, 1.10–1.81), widowed (HR: 1.71; 95% CI, 1.32–2.20), or never married (HR: 1.40; 95% CI, 0.97–2.03). The findings persisted after adjustment for medications and other socioeconomic factors. CONCLUSIONS: Marital status is independently associated with cardiovascular outcomes in patients with or at high risk of cardiovascular disease, with higher mortality in the unmarried population. The mechanisms responsible for this increased risk require further study.
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spelling pubmed-57789932018-01-26 Marital Status and Outcomes in Patients With Cardiovascular Disease Schultz, William M. Hayek, Salim S. Samman Tahhan, Ayman Ko, Yi‐An Sandesara, Pratik Awad, Mosaab Mohammed, Kareem H. Patel, Keyur Yuan, Michael Zheng, Shuai Topel, Matthew L. Hartsfield, Joy Bhimani, Ravila Varghese, Tina Kim, Jonathan H. Shaw, Leslee Wilson, Peter Vaccarino, Viola Quyyumi, Arshed A. J Am Heart Assoc Original Research BACKGROUND: Being unmarried is associated with decreased survival in the general population. Whether married, divorced, separated, widowed, or never‐married status affects outcomes in patients with cardiovascular disease has not been well characterized. METHODS AND RESULTS: A prospective cohort (inception period 2003–2015) of 6051 patients (mean age 63 years, 64% male, 23% black) undergoing cardiac catheterization for suspected or confirmed coronary artery disease was followed for a median of 3.7 years (interquartile range: 1.7–6.7 years). Marital status was stratified as married (n=4088) versus unmarried (n=1963), which included those who were never married (n=451), divorced or separated (n=842), or widowed (n=670). The relationship between marital status and primary outcome of cardiovascular death and myocardial infarction was examined using Cox regression models adjusted for clinical characteristics. There were 1085 (18%) deaths from all causes, 688 (11%) cardiovascular‐related deaths, and 272 (4.5%) incident myocardial infarction events. Compared with married participants, being unmarried was associated with higher risk of all‐cause mortality (hazard ratio [HR]: 1.24; 95% confidence interval [CI], 1.06–1.47), cardiovascular death (HR: 1.45; 95% CI, 1.18–1.78), and cardiovascular death or myocardial infarction (HR: 1.52; 95% CI, 1.27–1.83). Compared with married participants, the increase in cardiovascular death or myocardial infarction was similar for the participants who were divorced or separated (HR: 1.41; 95% CI, 1.10–1.81), widowed (HR: 1.71; 95% CI, 1.32–2.20), or never married (HR: 1.40; 95% CI, 0.97–2.03). The findings persisted after adjustment for medications and other socioeconomic factors. CONCLUSIONS: Marital status is independently associated with cardiovascular outcomes in patients with or at high risk of cardiovascular disease, with higher mortality in the unmarried population. The mechanisms responsible for this increased risk require further study. John Wiley and Sons Inc. 2017-12-20 /pmc/articles/PMC5778993/ /pubmed/29263033 http://dx.doi.org/10.1161/JAHA.117.005890 Text en © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Schultz, William M.
Hayek, Salim S.
Samman Tahhan, Ayman
Ko, Yi‐An
Sandesara, Pratik
Awad, Mosaab
Mohammed, Kareem H.
Patel, Keyur
Yuan, Michael
Zheng, Shuai
Topel, Matthew L.
Hartsfield, Joy
Bhimani, Ravila
Varghese, Tina
Kim, Jonathan H.
Shaw, Leslee
Wilson, Peter
Vaccarino, Viola
Quyyumi, Arshed A.
Marital Status and Outcomes in Patients With Cardiovascular Disease
title Marital Status and Outcomes in Patients With Cardiovascular Disease
title_full Marital Status and Outcomes in Patients With Cardiovascular Disease
title_fullStr Marital Status and Outcomes in Patients With Cardiovascular Disease
title_full_unstemmed Marital Status and Outcomes in Patients With Cardiovascular Disease
title_short Marital Status and Outcomes in Patients With Cardiovascular Disease
title_sort marital status and outcomes in patients with cardiovascular disease
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778993/
https://www.ncbi.nlm.nih.gov/pubmed/29263033
http://dx.doi.org/10.1161/JAHA.117.005890
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