Marital status, depressive episodes, and short-term prognosis of patients with acute coronary syndrome: Greek study of acute coronary syndrome (GREECS)

Demosthenes B Panagiotakos^1,3, Christos Pitsavos^2,3, Yannis Kogias³, Yannis Mantas³, Spyros Zombolos³, Antonis Antonoulas³, George Giannopoulos², Christina Chrysohoou², Christodoulos Stefanadis¹

¹Office of Biostatistics – Epidemiology, Department of Nutrition – Dietetics, Harokopio University, Athens, Greece; ²First Cardiology Clinic, School of Medicine, University of Athens, Greece; ³The GREECS Study Investigators, Greece

Abstract: The association between marital status and short-term prognosis of patients hospitalized for acute coronary syndrome (ACS) was evaluated. From October 2003 to September 2004, a sample of 6 hospitals located in Greek regions was selected, and almost all survivors after an ACS were enrolled into the study (2172 patients were included in the study; 76% were men). The in-hospital mortality rate was 3.2% in male patients and 5.7% in female patients (p = 0.009). Never-married patients had 2.8-times higher risk of dying during hospitalization compared with married, after adjusting for various confounders (p < 0.01, attributable risk = 64%). Furthermore, never-married had 2.7-times higher risk of dying during the first 30-days following hospitalization compared with married (p < 0.01, attributable risk = 62%). Moderate depressive symptoms 3.26-fold (95% CI 1.40–7.11) the risk of recurrent events, while severe depressive symptoms were associated with 8.2-fold (95% CI 3.98–17.1) higher risk of events. No interaction was observed between marital status and depression on 30-day prognosis of ACS patients (p > 0.5). People who were not-married and depressed at the time of an acute cardiac episode were at higher risk of fatal events than people who were married, irrespective of depression status and other characteristics.

Keywords: marital status, acute coronary syndromes, risk