Low perceived social support and post-myocardial infarction prognosis in the enhancing recovery in coronary heart disease clinical trial: The effects of treatment

Matthew M. Burg, John Barefoot, Lisa Berkman, Diane J. Catellier, Susan Czajkowski, Patrice Saab, Marc Huber, Vicki DeLillo, Pamela Mitchell, Judy Skala, C. Barr Taylor

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Objective: In post hoc analyses, to examine in low perceived social support (LPSS) patients enrolled in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial (n = 1503), the pattern of social support following myocardial infarction (MI), the impact of psychosocial intervention on perceived support, the relationship of perceived support at the time of MI to subsequent death and recurrent MI, and the relationship of change in perceived support 6 months after MI to subsequent mortality. Methods: Partner status (partner, no partner) and score (<12 = low support; >12 = moderate support) on the ENRICHD Social Support Instrument (ESSI) were used post hoc to define four levels of risk. The resulting 4 LPSS risk groups were compared on baseline characteristics, changes in social support, and medical outcomes to a group of concurrently enrolled acute myocardial infarction patients without depression or LPSS (MI comparison group, n = 408). Effects of treatment assignment on LPSS and death/recurrent MI were also examined. Results: All 4 LPSS risk groups demonstrated improvement in perceived support, regardless of treatment assignment, with a significant treatment effect only seen in the LPSS risk group with no partner and moderate support at baseline. During an average 29-month follow-up, the combined end point of death/nonfatal MI was 10% in the MI comparison group and 23% in the ENRICHD LPSS patients; LPSS conferred a greater risk in unadjusted and adjusted models (HR = 1.74-2.39). Change in ESSI score and/or improvement in perceived social support were not found to predict subsequent mortality. Conclusions: Baseline LPSS predicted death/recurrent MI in the ENRICHD cohort, independent of treatment assignment. Intervention effects indicated a partner surrogacy role for the interventionist and the need for a moderate level of support at baseline for the intervention to be effective.

Original languageEnglish
Pages (from-to)879-888
Number of pages10
JournalPsychosomatic Medicine
Volume67
Issue number6
DOIs
StatePublished - Nov 1 2005

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Social Support
Coronary Disease
Myocardial Infarction
Clinical Trials
Therapeutics
Mortality

Keywords

  • Acute coronary syndrome
  • Clinical trials
  • Social support

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Psychology(all)

Cite this

Low perceived social support and post-myocardial infarction prognosis in the enhancing recovery in coronary heart disease clinical trial : The effects of treatment. / Burg, Matthew M.; Barefoot, John; Berkman, Lisa; Catellier, Diane J.; Czajkowski, Susan; Saab, Patrice; Huber, Marc; DeLillo, Vicki; Mitchell, Pamela; Skala, Judy; Taylor, C. Barr.

In: Psychosomatic Medicine, Vol. 67, No. 6, 01.11.2005, p. 879-888.

Research output: Contribution to journalArticle

Burg, MM, Barefoot, J, Berkman, L, Catellier, DJ, Czajkowski, S, Saab, P, Huber, M, DeLillo, V, Mitchell, P, Skala, J & Taylor, CB 2005, 'Low perceived social support and post-myocardial infarction prognosis in the enhancing recovery in coronary heart disease clinical trial: The effects of treatment', Psychosomatic Medicine, vol. 67, no. 6, pp. 879-888. https://doi.org/10.1097/01.psy.0000188480.61949.8c
Burg, Matthew M. ; Barefoot, John ; Berkman, Lisa ; Catellier, Diane J. ; Czajkowski, Susan ; Saab, Patrice ; Huber, Marc ; DeLillo, Vicki ; Mitchell, Pamela ; Skala, Judy ; Taylor, C. Barr. / Low perceived social support and post-myocardial infarction prognosis in the enhancing recovery in coronary heart disease clinical trial : The effects of treatment. In: Psychosomatic Medicine. 2005 ; Vol. 67, No. 6. pp. 879-888.
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AU - Catellier, Diane J.

AU - Czajkowski, Susan

AU - Saab, Patrice

AU - Huber, Marc

AU - DeLillo, Vicki

AU - Mitchell, Pamela

AU - Skala, Judy

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