Reviews in cardiovascular medicine · 2026
Self-Rated Health as an Independent Predictor of All-Cause Mortality in Patients With Non-ST-Segment Elevation Myocardial Infarction.
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Cao Shan, Gu Tianshu, Hu Sutao, Liu Junyu, Liu Tong, Chen Kangyin
Аннотация
BACKGROUND: This investigation aimed to examine the association between subjective health perception and mortality risk in individuals diagnosed with non-ST-segment elevation myocardial infarction (NSTEMI).
METHODS: This study conducted a multicenter retrospective analysis of 29,465 patients with NSTEMI from 82 tertiary and secondary hospitals in Tianjin, China (2010-2023). Patients were stratified into self-rated health (SRH)-satisfied (n = 28,835) and SRH-dissatisfied (n = 630) cohorts based on self-reported health assessments. Propensity score matching (1:3 ratio) was used to balance baseline characteristics, yielding a final sample of 2514 patients. The primary outcome was all-cause mortality over a median follow-up of 1477 days. Multivariable Cox regression was used to identify predictors of mortality, and Kaplan-Meier analysis was performed to compare survival between groups.
RESULTS: The SRH-dissatisfied cohort exhibited advanced age, reduced percutaneous coronary intervention (PCI) utilization, and greater comorbidity burden (diabetes, hypertension, chronic kidney disease, cerebrovascular/peripheral vascular disease, chronic lung disease; p < 0.05). This group demonstrated significantly elevated mortality (adjusted Hazard Ratio [aHR] = 1.29, 95% confidence interval [CI]: 1.16-1.44; p < 0.001). No between-group differences were observed for secondary endpoints: nonfatal myocardial infarction (MI), cardiac death, ischemic stroke, or revascularization. Subgroup analyses stratified by age, sex, and comorbidity status confirmed the consistency of the results.
CONCLUSIONS: Self-rated health independently predicts mortality risk in patients with NSTEMI.
METHODS: This study conducted a multicenter retrospective analysis of 29,465 patients with NSTEMI from 82 tertiary and secondary hospitals in Tianjin, China (2010-2023). Patients were stratified into self-rated health (SRH)-satisfied (n = 28,835) and SRH-dissatisfied (n = 630) cohorts based on self-reported health assessments. Propensity score matching (1:3 ratio) was used to balance baseline characteristics, yielding a final sample of 2514 patients. The primary outcome was all-cause mortality over a median follow-up of 1477 days. Multivariable Cox regression was used to identify predictors of mortality, and Kaplan-Meier analysis was performed to compare survival between groups.
RESULTS: The SRH-dissatisfied cohort exhibited advanced age, reduced percutaneous coronary intervention (PCI) utilization, and greater comorbidity burden (diabetes, hypertension, chronic kidney disease, cerebrovascular/peripheral vascular disease, chronic lung disease; p < 0.05). This group demonstrated significantly elevated mortality (adjusted Hazard Ratio [aHR] = 1.29, 95% confidence interval [CI]: 1.16-1.44; p < 0.001). No between-group differences were observed for secondary endpoints: nonfatal myocardial infarction (MI), cardiac death, ischemic stroke, or revascularization. Subgroup analyses stratified by age, sex, and comorbidity status confirmed the consistency of the results.
CONCLUSIONS: Self-rated health independently predicts mortality risk in patients with NSTEMI.