Abstract 104: The Effect of Low Perceived Social Support on Health Outcomes in Young Patients with Acute Myocardial Infarction: Results from the VIRGO Study

Abstract

Background: Social support is an important predictor of health outcomes after acute myocardial infarction (AMI), but significant variability in social support exists by sex and age. Most studies have been conducted in populations of predominately older, male patients; little is known about the impact of social support on outcomes after AMI in young patients, who may have unique demands and resources. Methods: We used data from the VIRGO study, an observational study of patients aged ≤55 years with AMI in the US and Spain, to examine the association of low perceived social support (LPSS) with baseline and 1-year health status, depression, and quality of life. Patients were categorized as having low vs. moderate/high social support using the ENRICHD Social Support Inventory (ESSI), which was collected during the index AMI hospitalization. A modified 5-item version of the 7-item ESSI was used for this study in order to examine marital status and instrumental support separately from perceived social support. Outcomes included health status (assessed by the Short Form-12 (SF-12) physical and mental component scores (PCS and MCS)), depressive symptoms (Patient Health Questionnaire (PHQ-9)), and angina-related quality of life (Seattle Angina Questionnaire (SAQ)) evaluated at baseline and 1-year. We used linear regression to compare 1-year health status between social support categories, adjusting for baseline health status, socio-demographics, comorbidities, severity of disease, and therapies used. Results: Among 3,432 patients, 728 (21.2%) were classified as having LPSS. Men and women had comparable levels of social support at baseline. On average, patients with LPSS reported lower functional status (PCS and MCS), lower quality of life, and more depressive symptoms at baseline and 1-year post-AMI. After multivariable adjustment, including baseline health status, LPSS was associated with lower mental functioning (mean MCS -2.34 (95% confidence interval [CI] -3.35, -1.34) p<0.001), lower quality of life (mean SAQ -4.58 (95% CI -4.58, -2.57), p<0.001), and more depressive symptoms (1.01 (95% CI 0.52, 1.51), p<0.001) at 1 year. The relationship between LPSS and worse physical functioning was not significant after adjustment (mean PCS -0.28 (95% CI -1.33, 0.77), p=0.6). We observed no interactions between social support, sex or country. Conclusion: Lower social support is associated with worse health status and more depressive symptoms 1-year after AMI in both young men and women recovering from an AMI.