{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T23:27:10Z","timestamp":1780442830649,"version":"3.54.1"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,9,5]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Stress experienced in a marriage or committed relationship may be associated with worse patient\u2010reported outcomes after acute myocardial infarction (AMI), but little is known about this association in young adults (\u226455\u2009years) with AMI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We used data from VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), an observational cohort study that enrolled individuals aged 18 to 55\u2009years with AMI (2008\u20132012). Marital stress was self\u2010reported 1\u2009month after AMI using the Stockholm Marital Stress Scale (categorized as absent\/mild, moderate, and severe). Outcomes were physical\/mental health (Short Form\u201012\n              <jats:italic>)<\/jats:italic>\n              , generic health status (EuroQol\u20105 Dimensions), cardiac\u2010specific quality of life and angina (Seattle Angina Questionnaire), depressive symptoms (Patient Health Questionnaire\u20109), and all\u2010cause readmission 1\u2009year after AMI. Regression models were sequentially adjusted for baseline health, demographics (sex, age, race or ethnicity), and socioeconomic factors (education, income, employment, and insurance). Sex and marital stress interaction was also tested. Among 1593 married\/partnered participants, 576 (36.2%) reported severe marital stress, which was more common in female than male participants (39.4% versus 30.4%,\n              <jats:italic>P<\/jats:italic>\n              =0.001). Severe marital stress was significantly associated with worse mental health (beta=\u22122.13, SE=0.75,\n              <jats:italic>P<\/jats:italic>\n              =0.004), generic health status (beta=\u22123.87, SE=1.46,\n              <jats:italic>P<\/jats:italic>\n              =0.008), cardiac\u2010specific quality of life (beta=\u22126.41, SE=1.65,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and greater odds of angina (odds ratio [OR], 1.49 [95% CI, 1.06\u20132.10],\n              <jats:italic>P<\/jats:italic>\n              =0.023) and all\u2010cause readmissions (OR, 1.45 [95% CI, 1.04\u20132.00],\n              <jats:italic>P<\/jats:italic>\n              =0.006), after adjusting for baseline health, demographics, and socioeconomic factors. These associations were similar across sexes (\n              <jats:italic>P<\/jats:italic>\n              \u2010interaction all &gt;0.05).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The association between marital stress and worse 1\u2010year health outcomes was statistically significant in young patients with AMI, suggesting a need for routine screening and the creation of interventions to support patients with stress recovering from an AMI.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.030031","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T09:07:34Z","timestamp":1692263254000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of Marital Stress on 1\u2010Year Health Outcomes Among Young Adults With Acute Myocardial Infarction"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1803-0059","authenticated-orcid":false,"given":"Cenjing","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Chronic Disease Epidemiology Yale School of Public Health New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2861-1383","authenticated-orcid":false,"given":"Rachel P.","family":"Dreyer","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Yale School of Medicine New Haven CT USA"},{"name":"Department of Biostatistics Yale School of Public Health New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6183-1893","authenticated-orcid":false,"given":"Fan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Yale School of Public Health New Haven CT USA"},{"name":"Center for Methods in Implementation and Preventive Science Yale University New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1557-7713","authenticated-orcid":false,"given":"Erica S.","family":"Spatz","sequence":"additional","affiliation":[{"name":"Department of Chronic Disease Epidemiology Yale School of Public Health New Haven CT USA"},{"name":"Center for Outcomes Research and Evaluation Yale University School of Medicine New Haven CT USA"},{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4557-9437","authenticated-orcid":false,"given":"C\u00e9sar","family":"Caraballo\u2010Cordovez","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation Yale University School of Medicine New Haven CT USA"},{"name":"Section of Cardiovascular Medicine, Department 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