Marriage Could Improve Heart Attack Survival and Reduce Hospital Stay

Large study of hospital data suggests marital support improves survival and could save money


Newswise — Being married could improve your likelihood of surviving a heart attack and is associated with reduced length of hospital stay, according to research presented at the British Cardiovascular Society (BCS) Conference in Manchester today (1).

The team – a collaboration between researchers at institutions including Aston Medical School and the University of East Anglia – found that married people were 14 per cent less likely to die after a heart attack than single people. Married people were also, on average, likely to spend two fewer days in hospital than single people.

The study was performed by the ACALM (Algorithm for Comorbidities, Associations, Length of stay and Mortality) Study Unit. The algorithm has compiled a one million patient dataset utilising Hospital Episode Statistics (HES) data (2) from the North of England. Researchers studied over 25,000 patients with a heart attack diagnosis that took place between January 2000 and March 2013.

There are 188,000 hospital episodes attributed to heart attack in the UK each year, which is around one every three minutes (3). Improvements in diagnosis and treatment driven by research mean that around 7 out of 10 people now survive a heart attack.

It is not clear from this research why married people are more likely to survive a heart attack but the researchers feel the findings emphasise the importance of physical and emotional support after the event. Although previous studies have linked marriage to improved heart attack outcomes, this is the first study to suggest that marital status affects how quickly heart attack patients are discharged.

Being discharged from hospital sooner could be financially beneficial to the NHS – the average cost per day for a patient to stay on a surgical ward is up to £400 and it is estimated that reducing length of stays in cardiology alone could save the NHS up to £9.8 million (4, 5). And shorter stays can benefit patients as they are associated with a lower risk of hospital-acquired infections (6).

The researchers feel the results show the need for doctors to consider the psychosocial effects of a heart attack, and consider them as a risk factor, when treating and managing the discharge of a patient.

Dr Nicholas D. Gollop, Clinical Research Fellow in Cardiology and presenting author from the University of East Anglia, said:

“Our results should not be a cause for concern for single people who have had a heart attack. But they should certainly be a reminder to the medical community of the importance of considering the support a heart attack survivor will get once they’re discharged.”

The researchers hope to expand the ACALM dataset in future studies, where they will look at longer term outcomes and consider the impact of marital status on other heart conditions such as heart failure and also evaluate the impact of potential interventions such as cardiac rehab. Dr Rahul Potluri, Founder of the ACALM Study Unit and Clinical Lecturer at Aston Medical School, said:

“Our approach has already helped us perform research investigating the relationship between mental and physical health, and health services research particularly looking at the weekend effect. Utilising and analysing large data sets is essential to improve our understanding of medical conditions and to improve management options for patients.

“By looking at how larger numbers of heart attack patients do over a longer period of time in future research, we may be able to see additional psychosocial benefits of marriage, which can be targeted to further guide patient care.”

Recently a survey of BHF supporters found that one in three (30 per cent) heart attack survivors has suffered with anxiety or depression (7).

Dr Mike Knapton, Associate Medical Director at the British Heart Foundation (BHF), said:

“A heart attack can have both devastating physical and psychological effects – most of which are hidden from the outside world. These findings suggest the support offered by spouse can have a beneficial effect on heart attack survivors, perhaps helping to minimise the impact of a heart attack. “When you have your heart attack, whether you’re married or not, it’s important to remember that you are not alone. Enrolling on a cardiac rehabilitation course, for example, will help you to recover physically, psychologically, and also help you to meet people with similar experiences, who know what you’ve been through. At the BHF we would encourage all heart attack survivors to do cardiac rehab.”

Cem Hilmi, 42, from Palmer’s Green in London, was rushed into hospital three years ago after collapsing in the kitchen. Cem’s support from his wife, Rosa, and the rest of his family has helped him to recover. Cem said:

“After feeling a bit unwell and some numbness in my arm, it turned out that I’d had at least three serious heart attacks and needed emergency surgery. I was a keen runner but after the heart attack I couldn’t even get up the stairs on my own. Your life changes in one instant.

“I was determined to physically get better, but the emotional impact was huge and at times seemed the greatest obstacle to my recovery. With support from family, particularly my wife, friends, my local cardiac rehabilitation team, and of course the BHF, I overcame the emotional and physical barriers. Six months after the heart attack, fully recovered, I was able to do a half marathon and take part in other events to raise money for the BHF.”

Find out more about the British Cardiovascular Society Conference at www.bcs.com/conference.

ENDS

To request interviews or for more information please call the BHF press office on 020 7554 0164 or 07764 290 381 (out of hours) or email newsdesk@bhf.org.uk

Notes to Editors

1) Abstract available here: http://www.bcs.com/abstracts3/marker_view.asp?AbstractID=1904. A recent publication relating to this research is also available: http://www.internationaljournalofcardiology.com/article/S0167-5273(16)30476-4/abstract2) Information about HES Data: http://www.hscic.gov.uk/hesdata3) BHF Cardiovascular Disease Statistics 2015. Available online: https://www.bhf.org.uk/research/heart-statistics4) Heart UK. The big question: The future of Acute Coronary Syndromes patient outcomes report. 2011. Available here: http://www.heartuk.org.uk/files/uploads/Big_Question_HUK_ACS2020Report.pdf5) NHS Improving Quality. NHS better care, better value indicators. 2015. [cited 2016 Jan 15]. Available here: http://www.productivity.nhs.uk/6) S. Hopkins, K. Shaw, L. Simpson, English National Point Prevalence Survey onHealthcare-associated Infections and Antimicrobial Use 2011. Available here: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/331871/English_National_Point_Prevalence_Survey_on_Healthcare_associated_Infections_and_Antimicrobial_Use_2011.pdf7) BHF survey of 152 Heart Matters readers, carried out by Toluna, w/c 1 March 2016

About the British Cardiovascular Society (BCS)BCS is the voice for those working in cardiovascular health, science and disease management in the UK; we aim to promote and support both the healthcare professionals who work in cardiology and the patients for whom we want to encourage the best possible treatment. Our members are healthcare professionals, working in the field of cardiovascular health.Find out more at http://www.bcs.com

British Heart FoundationCoronary heart disease is the UK’s single biggest killer. For over 50 years we’ve pioneered research that’s transformed the lives of people living with heart and circulatory conditions. Our work has been central to the discoveries of vital treatments that are changing the fight against heart disease. But so many people still need our help. From babies born with life-threatening heart problems to the many Mums, Dads and Grandparents who survive a heart attack and endure the daily battles of heart failure. Every pound raised, minute of your time and donation to our shops will help make a difference to people’s lives. Find out more at http://www.bhf.org.uk

About Aston UniversityFounded in 1895 and a University since 1966, Aston University has been always been a force for change. For 50 years the University has been transforming lives through pioneering research, innovative teaching and graduate employability success. Aston is renowned for its opportunity enabler through broad access and inspiring academics, providing education that is applied and has real impact on all areas of society, business and industry. True to Aston’s Coat of Arms which bears the word ‘Forward’, in 2016 Aston will hold a year-long anniversary celebration to recognise its heritage and achievements, but with a focus to drive forward the next stage in the University’s exciting journey. http://www.aston.ac.uk/50

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