This study conducted a pooled analysis of 891 patients with stable coronary heart disease from two prospective cohort studies. All patients received psychological assessments at enrollment, including depression, anxiety, anger, stress, and post-traumatic stress disorder.
The study was followed for 5.9 years, and the endpoints were cardiovascular death, nonfatal myocardial infarction, and heart failure hospitalization.
The study showed that in both cohorts, patients in the highest tertile of psychological scores had higher rates of first and recurrent nonfatal MI compared with patients in the lowest tertile of psychological scores.
Anger (Piqsels)
After combining the two cohorts, compared with patients in the lowest tertile of psychological scores, patients in the highest tertile had a 127% increased risk of endpoint events, and patients in the second tertile had a 52% increased risk. Adjustment for demographic and clinical risk factors only slightly attenuated this association.
When the scores were incorporated into traditional clinical risk models, predictive power improved significantly.
Psychological stress is the process of changes in psychological and physiological functions caused by the stimulation of stressors by the human body through recognition and evaluation. It can affect the functions of multiple systems such as cardiovascular and cerebrovascular systems through the neuro-humoral-immune regulatory mechanism, and is many The direct cause or trigger of a fatal disease.
Recently, a two-way two-sample Mendelian randomization study in this journal showed that there is a causal relationship between myocardial infarction and an increased risk of depression.
The American Heart Association (AHA) also issued a scientific statement recommending that for patients with cardiovascular disease and individuals at high cardiovascular risk, clinicians should routinely assess psychological and mental health, just as they would assess for hypertension, diabetes, or hyperlipidemia. .
source:
Mariana Garcia, Kasra Moazzami, Zakaria Almuwaqqat, et al. Psychological Distress and the Risk of Adverse Cardiovascular Outcomes in Patients With Coronary Heart Disease. JACC Adv. 2024 Feb, 3 (2) 100794.
2024-01-24 10:12:33
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