Frequency of Sexual Activity and Long-term Survival after Acute Myocardial Infarction

Am J Med. 2020 Jan;133(1):100-107. doi: 10.1016/j.amjmed.2019.06.019. Epub 2019 Jul 8.

Abstract

Background: Previous studies have shown an inverse relationship between sexual activity and mortality in the general population. We evaluated the association between sexual activity and long-term survival among patients with acute myocardial infarction.

Methods: Patients aged ≤65 years (n=1120; mean age, 53) discharged from 8 hospitals in central Israel after first myocardial infarction from 1992-1993 were followed for mortality through 2015. Frequency of sexual activity was self-reported during the index hospitalization (baseline; referring to the year preceding the infarct) and after 5 and 10-13 years, along with sociodemographic and clinical data. Cox proportional hazards models were constructed to estimate the association with all-cause mortality in time-dependent sexual activity categories.

Results: At baseline, a > once per week frequency of sexual activity was reported by 42% of the patients, whereas no sexual activity was reported by 6%. After 10-13 years, the rates were 21% and 27%, respectively. Lower sexual activity was associated with older age, female sex, lack of a steady partner and more comorbidities. During follow-up, 524 deaths (47%) occurred. An inverse relationship was observed between sexual activity frequency and death, with hazard ratios (95% confidence intervals) of 0.30 (0.23-0.38) for > once per week, 0.36 (0.28-0.46) for once per week, and 0.53 (0.42-0.66) for < once per week, compared with none. After adjusting for relevant confounding factors, the estimates were attenuated to 0.68 (0.50-0.91), 0.63 (0.48-0.83), and 0.72 (0.57-0.93), respectively (P for trend = .004).

Conclusions: Using repeated assessments of sexual activity after myocardial infarction, an inverse association was demonstrated with mortality, which was only partly accounted for by measured potential confounders.

Keywords: Longitudinal study; Myocardial infarction; Secondary prevention; Sexual activity; Survival.

MeSH terms

  • Age Factors
  • Comorbidity
  • Female
  • Humans
  • Israel / epidemiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mortality*
  • Myocardial Infarction / epidemiology*
  • Proportional Hazards Models
  • Sex Factors
  • Sexual Abstinence / statistics & numerical data
  • Sexual Behavior / statistics & numerical data*
  • Survival Rate