Psychosocial Risk Factors for Acute Myocardial Infarction: Results of a Case-Control Study in a Teaching Hospital at Karachi, Pakistan

Objective: To determine psychosocial risk factors for acute myocardial infarction at a teaching hospital in Karachi. Methods: One hundred and fifty three cases were recruited from cardiology clinics and 153 controls from internal medicine and family medicine clinics of Aga Khan University Hospital, Karachi, through non-probability sampling using a structured questionnaire. Cases were those who were diagnosed with acute myocardial infarction for the first time in past month. Controls were selected from family medicine and internal medicine clinics of the same hospital and included patients above the age of 40 years without acute myocardial infarction. Associations between psychosocial risk factors and acute myocardial infarction were investigated using multiple logistic regressions. Results: The psychosocial risk factors associated with acute myocardial infarction were irritability at home (OR: 4.86, 95% CI: 3.24-7.53), self-illness (OR: 3.33, 95% CI: 2.86-5.23), illness in family (OR: 8.44, 95% CI: 6.21-10.1), loss of job (OR: 3.71, 95% CI: 1.16-8.86) and death in family (OR: 7.42, 95% CI: 3.98-10.12) in fully adjusted models. Conclusions: Psychosocial risk factors are associated with acute myocardial infarction. Therefore, regular screening for these risk factors should be undertaken by physicians to identify high risk patients.