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Self‐assessed Physical Health Predicts 10‐Year Mortality After Myocardial Infarction

Parakh, Kapil MD, MPH; Bhat, Utsav; Thombs, Brett D. PhD; Fauerbach, James A. PhD; Bush, David E. MD; Ziegelstein, Roy C. MD

Journal of Cardiopulmonary Rehabilitation & Prevention: January/February 2010 - Volume 30 - Issue 1 - p 35–39
doi: 10.1097/HCR.0b013e3181c85a11
Cvd Secondary Prevention

PURPOSE: In spite of their widespread use in other fields, global measures of health are not commonly used in determining the prognosis of patients with myocardial infarction (MI). The objective of the present study was to ascertain the relationship between self-assessed physical health at the time of the MI and long-term mortality.

METHODS: This was a prospective cohort study of 284 patients with MI admitted to an academic community hospital between July 1995 and December 1996 who completed the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The physical component scale from the SF-36 was used as a self-assessment of physical health. All-cause mortality was assessed 10 years later by using the Social Security Death Index.

RESULTS: Patients with lower self-reported physical health were significantly more likely to be women; older; depressed; have a history of coronary artery disease; have a family history of MI; have a non–Q wave MI; have a Killip class 3 or 4 MI; have hypertension, diabetes mellitus, renal insufficiency, and chronic obstructive pulmonary disease; and have a longer hospitalization period. Patients with higher physical component scores had significantly lower mortality in the 10 years after MI and this persisted after adjusting for confounders (hazard ratio = 0.97 [95% CI 0.96–0.99], P = .001).

CONCLUSIONS: These data suggest that self-assessed physical health provides information on the long-term prognosis of patients with MI above and beyond that provided by traditional risk predictors.

This prospective cohort study at an academic community hospital of 284 patients admitted with myocardial infarction found that lower self-assessed physical health was associated with significantly higher mortality in the 10 years after myocardial infarction, even after adjusting for confounders.

Departments of Medicine (Drs Parakh, Bush, and Ziegelstein and Mr Bhat) and Psychiatry and Behavioral Sciences (Dr Fauerbach), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; and Sir Mortimer B. Davis Jewish General Hospital and McGill University, Montreal, Quebec, Canada (Dr Thombs).

Corresponding Author: Roy C. Ziegelstein, MD, Department of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, B-1-North, 4940 Eastern Ave, Baltimore, MD 21224 (rziegel@jhmi.edu).

© 2010 Lippincott Williams & Wilkins, Inc.