Recovery of self-rated health as a predictor of recurrent ischemic events after first myocardial infarction: A 13-year follow-up

Yael Benyamini*, Yariv Gerber, Noa Molshatzki, Uri Goldbourt, Yaacov Drory, Yeheskiel Kishon, Michael Kriwisky, Yoseph Rosenman, Hanoch Hod, Eliezer Kaplinsky, Michael Eldar, Itzhak Shapira, Amos Pines, Margalit Drory, Arie Roth, Shlomo Laniado, Gad Keren, Daniel David, Morton Leibowitz, Hana PausnerZvi Schlesinger, Zvi Vered, Alexander Battler, Alejandro Solodky, Samuel Sclarovsky, Izhar Zehavi, Rachel Marom-Klibansky, Ron Leor

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: Following the trajectory hypothesis for the validity of self-rated health (SRH), we tested whether subjective recovery of health, that is, return to the same or higher level of SRH after a major health event, independently predicts better long-term prognosis. Methods: Participants were 640 patients (≤65 years) admitted to the eight medical centers in central Israel with incident MI in a 1-year period (mean age 54, 17% female). Baseline data were collected within days of the index MI. SRH in the preceding year was assessed at baseline, and current SRH was assessed 3-6 months later. Recurrent ischemic events (recurrent MI, hospitalization with unstable angina pectoris, or cardiac death) were recorded during a mean follow-up of 13 years. Results: A reduced risk of recurrent events was associated with an upward change of one level (e.g., from 3 at T1 to 4 at T2) in SRH (HR = 0.76, 95%CI: 0.69-0.85), controlling for baseline retrospective SRH. Risk was still significantly lower for each unit of improvement after adjusting for sociodemographics, preevent comorbidity, cardiac risk factors, MI severity, and early post-MI events (HR = 0.85, 95% CI 0.75- 0.95). Conclusions: Individuals who perceived themselves 3-6 months after a first MI to be healthier than they had been in the year preceding the MI were more likely to survive event-free throughout the next 13 years, controlling for baseline retrospective SRH and multiple cardiac risk factors. Failure to experience such subjective recovery of one's health is a serious risk factor, which indicates that SRH should be monitored regularly after a MI.

Original languageEnglish
Pages (from-to)317-325
Number of pages9
JournalHealth Psychology
Issue number4
StatePublished - Apr 2014


  • Mortality
  • Myocardial infarction
  • Recovery
  • Recurrent ischemic events
  • Self-assessed health
  • Self-rated health


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