OBJECTIVES

The American College of Cardiology/American Heart Association (ACC/AHA) recommends health behavior for secondary prevention of myocardial infarction (MI). We compared health behaviors between MI survivors and propensity score matched non-MI controls.

METHODS

This study was a retrospective, cross-sectional, matched case-control study using publicly available Behavioral Risk Factor Surveillance System (BRFSS) 2015 data. The study included adults aged ≥ 50 years responding “yes” to the question, “has a doctor, nurse, or another health professional ever told you that you had a heart attack, also called a myocardial infarction?”. MI survivors were matched on propensity scores to non-MI controls (1:3) based on age, sex, race/ethnicity, and comorbidities using the greedy matching algorithm (8:1-digit match). Dependent variable (health behaviors) of this study consisted of physical activity, alcohol consumption, flu immunization, smoking status, body mass index (BMI), physical checkup, and fruits/vegetable consumption. Univariate (chi-squared test) and multivariable binomial logistic regression analyses were used to compare health behavior between MI survivors and propensity score matched non-MI controls.

RESULTS

The final study sample consisted of 17,675 MI survivors and 53,025 non-MI controls after propensity score matching. Multivariable analyses of health behaviors comparing MI survivors and non-MI controls after propensity score matching revealed that MI survivors were more likely to have their cholesterol checked within the past 2 years compared to controls (AOR=1.37, 95% CI: 1.17-1.61). However, they were more likely to be current smokers (AOR=1.30, 95% CI: 1.15-1.47), less likely to have a physical checkup within the past 2 years (AOR=0.82, 95% CI: 0.69-0.96) and engage in physical activity of at least 150 minutes/week (AOR=0.87, 95% CI: 0.80-0.94).

CONCLUSIONS

Based on this United States national-level survey, MI survivors exhibited poorer health behaviors compared to their propensity score matched non-MI controls. Despite ACC/AHA guidelines, health behaviors have continued to be suboptimal for secondary prevention of MI.