A positive outlook goes a long way toward enhancing survival after a heart attack.

Patients with coronary heart disease who have positive expectations about recuperation, expressing beliefs, for example, “I can still live a long and healthy life,” had greater long-term survival, specialists reported.

Among a cohort of just about 3,000 patients undergoing coronary angiography, those with the highest expectations for results really had the best results, Dr. John C. Barefoot, and colleagues from Duke University Medical Center in Durham, N.C.

“Patients differ widely in terms of their psychological responses to major illnesses, for example, coronary heart disease,” Barefoot’s group explained online in the Archives of Internal Medicine.

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To explore the particular potential impact of recovery expectations, rather than overall optimistic personality traits, the investigators enrolled 2,818 patients with clinically significant disease and followed them for around 15 years.

Recovery expectations were assessed on the Expectations for Coping Scale, in which patients concurred or disagreed with statements, for example, “I doubt that I will ever completely recover from my heart problems” and “My heart condition will have little or no effect on my capacity to do work.”

Patients were stratified into quartiles as indicated by their expectation scores.

After changes for multiple variables, the mortality rate in the most elevated quartile — the most optimistic group — was 32 for every 100 versus 46 per 100, respectively, “illustrating a substantial magnitude of this impact even after taking various covariates into account,” Barefoot and colleagues observed.

“These observations add to a convincing body of proof that endorsing optimistic expectations for one’s future heart health is related with clinically important benefits to cardiovascular results,” Dr. Ronald Epstein, and Dr. Robert Gramling, of the University of Rochester in New York, wrote in a commentary accompanying the study.

“The degrees of proof observed in these studies suggest that optimism is a capable ‘drug’ that compares favorably with highly effective medical therapies,” they wrote.

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