The Role of Sense of Coherence in the Outcomes of Acute Myocardial Infarction Survivors; a Two-year Cohort Study

Abstract Background: Survivors of acute myocardial infarction(AMI) struggle with stressful consequences. Sense of coherence(SOC) seems to be associated with a person's capacity to face life incidents. The current study aims to evaluate SOC's correlation with the major adverse cardiac events(MACE) among the AMI survivors. The study was designed and reported following the STROBE guidelines and checklist.Methods: This study was part of the ST-elevated myocardial infarction cohort study in Isfahan(SEMI-CI) conducted on 724 AMI survivors followed for two years. The patients' demographic, medical history and follow-up manifestations were recruited. The 13-item SOC questionnaire was utilized and the Diagnostic Criteria for Psychosomatic Research(DCPR) questionnaire for psychosomatic disorders evaluation, including health anxiety, illness denial, irritable mood, and demoralization. MACE was defined as non-fatal MI, non-fatal stroke, and atherosclerosis cardiovascular disease-related death was recorded. Results: Logistic regression assessments showed that the SOC level was an independent predictor for the development of MACE(OR:0.67; 95%CI:0.40-0.85). This finding was confirmed by the controlling factors, including demographic data(OR:0.60; 95%CI:0.35-0.79), demographic factors and medical history(OR:0.62; 95%CI:0.36-0.86), the previous ones plus clinical follow-up assessments(OR:0.59; 95%CI:0.33-0.79), and all the evaluations plus psychosomatic factors(OR:0.76; 95%CI:0.42-0.92). Similar outcomes were achieved using SOC scores.Conclusion: Based on this study, SOC was an independent MACE predictor in a large population of AMI patients through a 2-year-follow-up period.