Abstract 16483: Marital Status and Long-Term Mortality of Male Patients Presenting With Acute Myocardial Infarction

Abstract

Background: Although unmarried has been associated with an increased risk of acute coronary syndrome, little is known about the relationship between marital status and long-term mortality after acute myocardial infarction (AMI). Methods and Results: To elucidate the clinical characteristics and outcomes of AMI patients who have never married, the consecutive 364 male AMI patients (mean age; 63±13 years) admitted to our hospital were studied. Mean follow-up period was 1.7 years. The patients were divided into 2 groups by their marital status: those who had married at least one time (Married Group (MG), n=328) and those who had never married (Unmarried Group (UG), n=36 (9.9%)). UG patients were younger (54±11 vs 65±12 years, p<0.0001) and had a higher level of body mass index (BMI) (26.5±4.5 vs 24.1±3.5 kg/m2, p=0.0002) than MG. None of coronary risk factors including hypertension, dyslipidemia, diabetes mellitus and smoking habit, Killip classification, culprit lesion of AMI nor maximal creatine phosphokinase-MB (CPK-MB) level was different between 2 groups. The time from the symptom onset to admission was significantly longer in UG (6.1 (2.6-14.3) vs 3.8 (2.3-8.3) hours, p=0.033). Left ventricular ejection fraction (LVEF) assessed at the acute phase of AMI was not different between 2 groups. Kaplan-Meier Curve showed no significant difference of all-cause mortality between 2 groups (20% in UG vs 12% in MG, p=0.27 by Log-rank test). When the analysis is done in patients with the ages >50 years (272 patients in MG and 19 in UG), all-cause mortality tended to be higher in UG than in MG (38% vs 15%, p=0.098 by Log-rank test). After adjustment for age, Killip IV and LVEF at the acute phase, unmarried status was independently associated with all-cause long-term mortality after AMI (hazard ratio (HR); 3.84, 95% confidence interval (CI); 1.22-10.2, p=0.024). Conclusions: Unmarried status is independently associated with significantly increased all-cause long-term mortality in the male AMI patients with the ages >50 years.