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Int J Angiol 2023; 32(03): 179-187
DOI: 10.1055/s-0043-1767697
Original Article

Comparisons of Patients Living Alone versus Living with Others in Acute Coronary Syndrome

Yusaku Shibata
1   Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
,
Nobuaki Kobayashi 
2   Cardiovascular Center, Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
,
Akihiro Shirakabe
1   Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
,
Yasushi Miyauchi
2   Cardiovascular Center, Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
,
Kuniya Asai
1   Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
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Abstract

We aimed to examine the relationship of living arrangements (i.e., living alone or living with others) with background, clinical severity, preintervention culprit lesion plaque morphology, and clinical outcomes in patients with acute coronary syndrome (ACS).

Among 1,683 consecutive patients with ACS, we retrospectively compared patients living alone (n = 318) versus living with others (n = 1,362). Optical coherence tomography (OCT) findings, which are high-resolution intracoronary imaging devices, were analyzed in patients with preintervention OCT and compared between patients living alone (n = 174) versus those living with others (n = 665).

Older (median; 69 vs. 67 y, p = 0.046) and female (31 vs. 17%, p < 0.001) patients more frequently lived alone. Frequency of achieving a time interval of 6 hours or less from ACS onset to admission was lower in patients living alone (56 vs. 63%, p = 0.022). Clinical presentation was more severe in patients living alone (Killip II/III/IV; 27 vs. 22%, p = 0.029). Plaque morphology evaluated by OCT was similar between groups (plaque rapture; 48 vs. 48%, p = 0.171). Kaplan–Meier analyses revealed higher rates of cardiac mortality during 2-year follow-up period in patients living alone [13.9 vs. 8.5%, hazard ratio (HR) 1.604, 95% confidence interval (CI) 1.112–2.313, p = 0.010]. After traditional cardiovascular risk factors and clinical severity upon admission had been adjusted, living alone was an independent predictor of cardiac mortality in ACS patients (HR 1.582, 95% CI 1.056–2.371, p = 0.026). Living alone was independently associated with 2-year cardiacmortality in ACS patients after adjusting for background and presentation and might be unrelated to the development of atherosclerosis.

Keywords

living arrangement - myocardial infarction - optical coherence tomography


Publication History

Article published online:
12 April 2023

© 2023. International College of Angiology. This article is published by Thieme.

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