Zhu Cenjing, Tran Phoebe M, Leifheit Erica C, Spatz Erica S, Dreyer Rachel P, Nyhan Kate, Wang Shi-Yi, Lichtman Judith H
Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, 60 College Street, New Haven, CT 06510, USA.
Department of Public Health, University of Tennessee, 1914 Andy Holt Ave, Knoxville, TN 37996, USA.
Eur Heart J Open. 2023 Feb 28;3(2):oead018. doi: 10.1093/ehjopen/oead018. eCollection 2023 Mar.
Little is known about the relationship between marital/partner status and patient-reported outcome measures (PROMs) following myocardial infarction (MI). We conducted a systematic review/meta-analysis and explored potential sex differences.
We searched five databases (Medline, Web of Science, Scopus, EMBASE, and PsycINFO) from inception to 27 July 2022. Peer-reviewed studies of MI patients that evaluated marital/partner status as an independent variable and reported its associations with defined PROMs were eligible for inclusion. Results for eligible studies were classified into four pre-specified outcome domains [health-related quality of life (HRQoL), functional status, symptoms, and personal recovery (i.e. self-efficacy, adherence, and purpose/hope)]. Study quality was appraised using Newcastle-Ottawa Scale, and data were synthesized by outcome domains. We conducted subgroup analysis by sex. We included 34 studies ( = 16 712), of which 11 were included in meta-analyses. Being married/partnered was significantly associated with higher HRQoL {six studies [ = 2734]; pooled standardized mean difference, 0.37 [95% confidence interval (CI), 0.12-0.63], = 51%} but not depression [three studies ( = 2005); pooled odds ratio, 0.72 (95% CI, 0.32-1.64); = 65%] or self-efficacy [two studies ( = 356); pooled , 0.03 (95% CI, -0.09 to 0.14); = 0%]. The associations of marital/partner status with functional status, personal recovery outcomes, and symptoms of anxiety and fatigue were mixed. Sex differences were not evident due to mixed results from the available studies.
Married/partnered MI patients had higher HRQoL than unpartnered patients, but the associations with functional, symptom, and personal recovery outcomes and sex differences were less clear. Our findings inform better methodological approaches and standardized reporting to facilitate future research on these relationships.
关于心肌梗死（MI）后婚姻/伴侣状况与患者报告结局指标（PROMs）之间的关系，目前所知甚少。我们进行了一项系统评价/荟萃分析，并探讨了潜在的性别差异。
我们检索了从数据库创建至2022年7月27日的五个数据库（Medline、Web of Science、Scopus、EMBASE和PsycINFO）。对心肌梗死患者进行的同行评审研究，若将婚姻/伴侣状况作为自变量进行评估，并报告其与特定PROMs的关联，则符合纳入标准。符合条件的研究结果被分类为四个预先指定的结局领域[健康相关生活质量（HRQoL）、功能状态、症状和个人恢复（即自我效能感、依从性和目标/希望）]。使用纽卡斯尔-渥太华量表评估研究质量，并按结局领域对数据进行综合分析。我们按性别进行了亚组分析。我们纳入了34项研究（n = 16712），其中11项纳入了荟萃分析。已婚/有伴侣与较高的HRQoL显著相关{六项研究[n = 2734]；合并标准化均数差，0.37[95%置信区间（CI），0.12 - 0.63]，I² = 51%}，但与抑郁无关[三项研究（n = 2005）；合并比值比，0.72（95%CI，0.32 - 1.64）；I² = 65%]或自我效能感无关[两项研究（n = 356）；合并效应量，0.03（95%CI， - 0.09至0.14）；I² = 0%]。婚姻/伴侣状况与功能状态、个人恢复结局以及焦虑和疲劳症状之间的关联不一。由于现有研究结果不一，性别差异不明显。
已婚/有伴侣的心肌梗死患者的HRQoL高于无伴侣患者，但与功能、症状和个人恢复结局的关联以及性别差异尚不清楚。我们的研究结果为更好的方法学和标准化报告提供了依据，以促进未来对这些关系的研究。
