LONG-TERM PROGNOSIS OF LOW-RISK, POST-MI PATIENTS - THE IMPORTANCE OFSUBJECTIVE PERCEPTION OF DISEASE

In 1980, 87 male patients (age range 34-60 years), hospitalized after their first myocardial infarction (MI), were asked why they believed t hey got the infarct and what would help them cope with it. In a multip le regression analysis, their causal attributions accounted for 15% of the explained variance in their physical, sexual, social and work fun ctioning after 6 and 18 months, their level of education accounted for 25% and the severity of their infarct for 10%. This result was replic ated in a cross-cultural study. A follow-up study shows that 12 years after the MI, the patients' initial causal attributions still accounte d for part of their rehabilitation and life expectancy. Of the origina l 87, 23 had died between 1980-1992 from cardiac causes and 50 male pa tients were located and re-interviewed at the Soroka ICCU, in 1992. Th is suggests a very low-risk post-MI sample. The only risk-factor, acco unting for the difference between the surviving and the deceased patie nts, was the initial obesity of the latter. The functional capacity ou tcome of the survivors was accounted for by their age (24%) and initia l causal attributions (26%). Also the initial causal attributions (5%) still accounted for the subjective perception of functioning among th e survivors. These results suggest that the initial causal attribution s may have created positive or negative self-fulfilling prophecies whi ch had long-term consequences, especially in a low-risk, post-MI popul ation, in which risk factors hardly effected long-term prognosis.