The influence of social support on health outcomes in patients with acute coronary syndrome: a prospective study from China
Sha Lei1 DayiHu1 LiWang1 RongjingDing2
1.Department of cardiology, the First Affiliated Hospital of Chongqing Medical University
2.People’s Hospital of Peking University
Objectives: Social support is generally identified to associated with heath-related quality of life(HRQoL) and prognosis among patients with coronary heart disease(CHD). Few study described the changes of social support during follow-up. We evaluated the changes of social support at 12 months and taken anxiety into account for health outcomes of acute coronary syndrome(ACS) patients in mainland China.
Methods: 778 patients with ACS were consecutively enrolled in the study within 7 days after admission from 5 hospitals in Beijing China. Social support(ENRICHD Social Support Inventory),health status(Short Form-12 physical and mental component scores),anxiety(Anxiety Disorder-7 scale),depressive symptoms(Patients Health Questionnaire),and angina-related quality of life(Seattle Angina Questionaire) were investigated at baseline and 12 months. Mortality, recurrent angina, non-fatal myocardial infarction and re-hospitalization were observed during 12 months follow-up
Results: Patients with low social support at baseline presented more anxiety, worse mental functioning and angina-related quality of life than patients with moderate/high social support(all p<0.05).Mortality and non-fatal myocardial infarction were low in the overall cohort and not differ by social support(P>0.05).Whereas, patients with low social support at baseline were at greater risk of a recurrent angina(HR1.16,95%CI1.06-2.62,p<0.05) and rehospitalization(HR2.16,95%CI1.16-4.05,p<0.05) than those who had moderate/high social support over follow-up period.In average social support and health-related quality of life had been significantly improved regardless of baseline social support level at 12 month(all p<0.01)
Conclusions: Low social support was a predictor for worse health outcomes and recurrent angina, re-admission among Chinese ACS patients. Social support level experienced an improvement at 12 months post-ACS. Future studies is needed to figure out the mechanism of social support change and to develop the specific intervention for social support.