2017


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2017/№1

Functional social support for patients with ischemic heart disease after coronary stenting

Pushkarev G. S., Kuznetsov V. A., Yaroslavskaya E. I., Bessonov I. S.
"Tyumen Cardiology Science Center", Branch of the Federal State Budgetary Science Institution, "Tomsk National Research Medical Center of the Russian Academy of Sciences", Melnikayte 111, Tyumen 625026

Keywords: coronary heart disease, social support, psychosocial risk factors

DOI: 10.18087/rhj.2017.1.2274

Background. Insufficient social support is known to impair survival rate and prediction for patients with clinical manifestations of cardiovascular diseases (CVD). Aim. To evaluate functional social support and its relationship with clinical instrumental indices in patients with ischemic heart disease (IHD) after transcutaneous coronary interventions (TCI) and to determine the functional social support influence on prognosis of these patients within one year after the surgery. Material and methods. This prospective study included all patients who had undergone emergency and elective TCIs for hemodynamically significant coronary stenosis in the Tyumen Cardiology Center between October 15, 2012 and November 15, 2013. In total, 108 patients (764 men and 254 women aged 33 to 90 (mean age, 58.9±9.7) were evaluated. A Russian-language version of the MSPSS scale was used for determining levels of social support. Mean duration of the prospective observation was 12.0±1.8 months. A multivariate regression model of Cox proportional hazards was used for evaluation of hazard ratio (HR) for all-cause death and death due to cardiovascular diseases (CVD). Results. The mean MSPSS score was 70.0±12.3. Low levels of social support were observed in 5.7% of patients, moderate levels – in 30.4%, and high levels – in 63.9%of patients. The groups did not differ in major clinical, functional and laboratory parameters. Patients with low and moderate levels of social support were older than patients with high levels (60.4±9.9 vs. 57.7±9.2, р=0.09 and 60.2±9.4 vs. 57.7±9.2, р=0.001, respectively). Men prevailed among patients with high levels of social support (79.2% vs. 70.0% in the group with moderate levels, р=0.01). Patients with low social support had FC III–IV chronic heart failure more frequently than patients with high social support (32.1% vs. 20.7%, р=0.05). For the period of prospective observation, 24 all-cause deaths (2.4%) and 21 deaths due to CVD (2.1%) were observed. The HR score for social support was 0.963 (95% CI, 0.939–0.989) for all-cause death and 0.969 (95% CI, 0.941–0.997) for death due to CVD. For patients with low levels of social support, the HR was 4.75 (95% CI, 1.45–15.6) for all-cause death and 3.96 (95% CI, 1.03–15.3) for death due to CVD. Conclusion. The level of social support depended on age and gender and was related with CHF severity. Social support significantly and independently influenced the risk of death in patients with IHD after TCI.
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Pushkarev G.S., Kuznetsov V.A., Yaroslavskaya E.I., Bessonov I.S. Functional social support for patients with ischemic heart disease after coronary stenting. Russian Heart Journal. 2017;16 (1):66–72.

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