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Association between marital status and in-hospital mortality in patients with acute coronary syndrome: a

Lingling Zhang1, Li Peng2, Zhican Liu3

  • 1Medical Department, Xiangtan Central Hospital, The Affiliated Hospital of Hunan University, Xiangtan, China.

Frontiers in Cardiovascular Medicine
|February 26, 2026
PubMed

Insights

Marital status significantly impacts acute coronary syndrome (ACS) patient outcomes. Unmarried ACS patients face a substantially higher risk of in-hospital death, highlighting its role as an independent predictor.

Area of Science:

  • Cardiology
  • Public Health
  • Medical Prognostics

Background:

  • Marital status is recognized as a potential prognostic factor in acute coronary syndrome (ACS).
  • The independent effect of marital status on in-hospital mortality among ACS patients requires further investigation.

Purpose of the Study:

  • To investigate the association between marital status and in-hospital mortality in patients with ACS.
  • To develop a predictive scoring system for in-hospital mortality, evaluating marital status as an independent risk factor.

Main Methods:

  • Analysis of 12,760 ACS patients, categorized by in-hospital outcomes and marital status.
  • Multivariable logistic regression to assess marital status as an independent predictor of mortality.
  • Validation of a predictive model using ROC curve and decision curve analysis (DCA).

Main Results:

  • Unmarried status was significantly linked to increased in-hospital mortality (OR=5.40, P<0.0001).
  • Multivariable analysis confirmed marital status as an independent risk factor (OR=4.20, P=0.0003).
  • The developed predictive model, incorporating marital status, demonstrated high accuracy (AUC=0.972).

Conclusions:

  • Marital status is a crucial independent predictor of in-hospital mortality in ACS patients.
  • Unmarried individuals with ACS exhibit a significantly elevated risk of in-hospital death.
Abstract

Keywords:
acute coronary syndromein-hospital mortalityindependent risk factormarital statusmultivariable logistic regressionpredictive model.

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