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.
RCT Entities:
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 infarctionpatients 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 LPSSpatients; 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.
Authors: Rachel P Dreyer; Kumar Dharmarajan; Kevin F Kennedy; Philip G Jones; Viola Vaccarino; Karthik Murugiah; Sudhakar V Nuti; Kim G Smolderen; Donna M Buchanan; John A Spertus; Harlan M Krumholz Journal: Circulation Date: 2017-02-07 Impact factor: 29.690
Authors: Misook L Chung; Terry A Lennie; Barbara Riegel; Jia-Rong Wu; Rebecca L Dekker; Debra K Moser Journal: Am J Crit Care Date: 2009-11 Impact factor: 2.228
Authors: Olivia R Ghosh-Swaby; Mary Tan; Akshay Bagai; Andrew T Yan; Shaun G Goodman; Shamir R Mehta; Harold N Fisher; Eric A Cohen; Thao Huynh; Warren J Cantor; Michel R Le May; Jean-Pierre Déry; Robert C Welsh; Jacob A Udell Journal: Clin Cardiol Date: 2018-03-25 Impact factor: 2.882
Authors: Connie White-Williams; Kathleen L Grady; David C Naftel; Susan Myers; Edward Wang; Bruce Rybarczyk Journal: Clin Transplant Date: 2012-12-30 Impact factor: 2.863
Authors: Jia-Rong Wu; Susan K Frazier; Mary Kay Rayens; Terry A Lennie; Misook L Chung; Debra K Moser Journal: Health Psychol Date: 2012-07-02 Impact factor: 4.267
Authors: Yaakov S Green; Alexandra M Hajduk; Xuemei Song; Harlan M Krumholz; Samir K Sinha; Sarwat I Chaudhry Journal: Am J Cardiol Date: 2019-11-06 Impact factor: 2.778