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Background <p>Few studies exist on the impact of social support on cardiac events following implantation of implantable cardioverter-defibrillators (ICD) or cardiac resynchronization therapy devices with defibrillators (CRT-D). This study aims to investigate the longitudinal association between social support and adverse cardiac events among ICD/CRT-D recipients during a 1-year follow-up.</p> Methods <p>This hospital-based longitudinal study included 101 patients undergoing first ICD/CRT-D implantation. Demographic and clinical data were collected as confounders. Social support, anxiety, and depression scores were assessed at baseline and during follow-ups (1, 3, 6, 12 months). Cardiac events (primary endpoint: all-cause mortality or appropriate ICD shocks; secondary endpoint: primary endpoint events, heart failure hospitalization, or acute coronary syndrome) were documented. Kaplan-Meier analyses and Cox proportional hazards models (adjusted for age, sex, NYHA class, and ICD indication) evaluated associations, while time-dependent Cox models analyzed temporal effects.</p> Results <p>Patients with higher baseline social support exhibited a reduced risk of the primary composite endpoint (log-rank χ² = 5.53, <i>p</i> = 0.019) and secondary composite endpoint (log-rank χ² = 14.64, <i>p</i> &lt; 0.001). After multivariable adjustment (age, sex, NYHA class, ICD indication, anxiety/depression scores), high social support was independently linked to 65.6% lower secondary endpoint risk (adjusted HR = 0.344, 95% CI: 0.172–0.688, <i>p</i> = 0.003). The protective association attenuated over time (HR = 0.991 per unit time, <i>p</i> = 0.009) but remained statistically significant. Anxiety and depression showed no baseline association with events but demonstrated a time-dependent risk increase.</p> Conclusion <p>Higher social support is independently associated with a reduced risk of the secondary composite endpoint after ICD/CRT-D implantation. Sustained psychosocial interventions may be warranted to mitigate long-term risk attenuation.</p>

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High social support is associated with reduced cardiac events in patients following ICD/CRT-D implantation: a one-year follow-up study in China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月30日

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  • Pan Jing,
  • Shaoshan Pang,
  • Lirui Yu,
  • Si Lu,
  • Hongyan Cai,
  • Zhao Hu,
  • Min Zhang

摘要

Background

Few studies exist on the impact of social support on cardiac events following implantation of implantable cardioverter-defibrillators (ICD) or cardiac resynchronization therapy devices with defibrillators (CRT-D). This study aims to investigate the longitudinal association between social support and adverse cardiac events among ICD/CRT-D recipients during a 1-year follow-up.

Methods

This hospital-based longitudinal study included 101 patients undergoing first ICD/CRT-D implantation. Demographic and clinical data were collected as confounders. Social support, anxiety, and depression scores were assessed at baseline and during follow-ups (1, 3, 6, 12 months). Cardiac events (primary endpoint: all-cause mortality or appropriate ICD shocks; secondary endpoint: primary endpoint events, heart failure hospitalization, or acute coronary syndrome) were documented. Kaplan-Meier analyses and Cox proportional hazards models (adjusted for age, sex, NYHA class, and ICD indication) evaluated associations, while time-dependent Cox models analyzed temporal effects.

Results

Patients with higher baseline social support exhibited a reduced risk of the primary composite endpoint (log-rank χ² = 5.53, p = 0.019) and secondary composite endpoint (log-rank χ² = 14.64, p < 0.001). After multivariable adjustment (age, sex, NYHA class, ICD indication, anxiety/depression scores), high social support was independently linked to 65.6% lower secondary endpoint risk (adjusted HR = 0.344, 95% CI: 0.172–0.688, p = 0.003). The protective association attenuated over time (HR = 0.991 per unit time, p = 0.009) but remained statistically significant. Anxiety and depression showed no baseline association with events but demonstrated a time-dependent risk increase.

Conclusion

Higher social support is independently associated with a reduced risk of the secondary composite endpoint after ICD/CRT-D implantation. Sustained psychosocial interventions may be warranted to mitigate long-term risk attenuation.