Background: Narrative Medicine captures the lived experience of acute myocardial infarction (AMI) and may reveal sex- and gender-related patterns that shape symptom interpretation, emergency activation, adherence and rehabilitation. NARGEN maps post-AMI narratives to generate actionable targets for personalized secondary prevention. Methods: NARGEN is an observational, single-centre narrative-medicine study at Santo Stefano Hospital (Prato, Italy), coordinated with the University of Florence. Consecutive patients aged 30–70 years with AMI within the previous 12 months underwent a structured follow-up visit and a psychologist-led semi-structured interview (18 items) on symptoms and delays, emotions/coping, perceived recurrence risk, medication beliefs and adherence, lifestyle change, social support and role/identity. Ethics approval: Regional Ethics Committee of Tuscany, No. 28624_OSS (08-Apr-2025). Analyses combined thematic mapping with exploratory keyword-density metrics (occurrences/1000 words) and between-sex comparisons. Interviews were audio-recorded, transcribed verbatim and anonymized. Results: From July 1 to September 30, 2025, 50 patients completed follow-up (mean age 58±7.5 years; 24 women). Self-reported adherence was high (statins 95%, dual antiplatelet therapy 98%). Forty-six transcripts were available. A “minimization/waiting” pattern before calling emergency services emerged in 52% of accounts, often linked to atypical symptoms and competing responsibilities. Fear/anxiety was highly salient in 76% overall (women 95% vs men 63%); fear of recurrence/need for control in 78%; social support in 87%. Requests for clearer and repeated discharge information and post-event psychological support were frequent. Role pressure was often narrated as both a trigger for delay and a barrier to recovery. Women used more help-seeking language than men (median 2.10 vs 1.12/1000 words; p=0.002) and more role-related terms (3.50 vs 2.51; p=0.020), whereas men used more lifestyle-change language (3.64 vs 1.98; p=0.024). Conclusions: Interim NARGEN findings show that post-AMI narratives consistently foreground uncertainty, emotional burden and information needs, with measurable sex/gender differences in how patients frame illness and recovery. Embedding narrative-informed communication, reinforced discharge education and early psychological support may improve shared decision-making, rehabilitation uptake and sustained adherence in secondary prevention.
Associazione Nazionale Medici Cardiologi Ospedalieri
