Observational studyEnvironmental health and preventive medicine2026
Association between marital status and mortality risk in cardiac disease: a cardiopulmonary exercise testing cohort study.
Observational study in Environmental health and preventive medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough marital status is a key social determinant of health, its prognostic relevance in cardiopulmonary exercise testing (CPX) cohorts remains unclear. We aimed to evaluate the association between marital status and mortality risk in patients with cardiac disease (CD) who underwent CPX.
methodsThis retrospective, single-center observational study involved consecutive patients with CD who underwent post-discharge CPX between 2008 and 2020. Participants (mean age: 69 years; 73% male) were categorized as either unmarried (never married, divorced, or widowed) or married. The primary outcome was all-cause mortality, and the secondary outcome was cardiovascular mortality. We used Cox proportional hazards models to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Model 1 was adjusted for age and sex to estimate the overall association between marital status and outcomes. Model 2 was adjusted for Model 1 covariates and peak VO
resultsOf 4,681 patients analyzed, 1,117 were unmarried and 3,564 were married. In Model 1, being married was associated with a lower risk of all-cause mortality (aHR: 0.75, 95% CI: 0.62-0.91, P < 0.001). This association persisted after adjusting for peak VO
conclusionsIn a large CPX cohort of patients with CD, married status was associated with a lower risk of all-cause mortality. The association was attenuated but remained after adjustment for peak VO
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