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Spirituality, Religion, and Clinical Outcomes in Patients Recovering From an Acute Myocardial Infarction

From the Department of Psychiatry and Behavioral Sciences (J.A.B., M.A.B., F.J.K., P.S.), Duke University Medical Center, Durham, North Carolina; Department of Psychiatry (G.I.), University of Miami, Miami, Florida; School of Education (C.T.), Stanford University, Stanford, California; Department of Community Medicine (L.P.), Rush-Presbyterian Hospital, Chicago, Illinois; Department of Psychology (M.B.), Yale-New Haven Veterans Administration Hospital, New Haven, Connecticut; National Heart Lung and Blood Institute (S.C.), Bethesda, Maryland; and Department of Biostatistics (D.C.), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

View larger version (11K): [in this window] [in a new window]   Figure 1. Risk of death or recurrent myocardial infarction (MI) among 503 post MI patients associated with frequency of worship service attendance (left panel) and frequency of prayer (right panel) along with adjustment covariates (i.e., Medical Risk score, Gender, Ethnicity, and Education). There were 61 events (29 deaths, 32 MIs). Values represent point estimate of hazard ratio (HR) and 95% Confidence limits from multivariable Cox proportional hazards model. HRs for Attendance and Prayer represent comparison to "Never" category of variable. Medical Risk is modeled as a continuous variable, scaled such that the HR compares a typical patient with a score of 3.1 (75th percentile value of Medical Risk in the present sample) with a patient with a score of 2.1 (25th percentile value of Medical Risk in the present sample). The omnibus test for the overall effect of Attendance was not statistically significant (p = .107). The omnibus test for the overall effect of Prayer also was not statistically significant (p = .679).

View larger version (6K): [in this window] [in a new window]   Figure 2. Predicted probability of death or recurrent myocardial infarction as a function of the total Daily Spiritual Experiences scale (DSE) score, for a non-Hispanic white male patient with an average medical risk composite score using a restricted cubic spline to model nonlinearity. Dotted lines represent 95% Confidence bands. The relationship between the total Spiritual Experiences score and time to event was not statistically significant before adjustment for background variables (p = .086) or after adjustment (p = .446).