Prevalence and Prognostic Value of Psychological Stress Events in Patients with First Myocardial Infarction—Long-Term Follow-Up Study
While there is good evidence that symptoms of depression determine prognosis of patients with coronary heart disease (CHD), the role of psychological stress is less clear. We evaluated the prognostic value of stressful events in patients with initial myocardial infarction (MI) with respect to subseq...
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MDPI AG
2021-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/16/3562 |
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| author | Andrea Jaensch Ben Schöttker Roman Schmucker Wolfgang Koenig Hermann Brenner Dietrich Rothenbacher |
| author_facet | Andrea Jaensch Ben Schöttker Roman Schmucker Wolfgang Koenig Hermann Brenner Dietrich Rothenbacher |
| author_sort | Andrea Jaensch |
| collection | DOAJ |
| description | While there is good evidence that symptoms of depression determine prognosis of patients with coronary heart disease (CHD), the role of psychological stress is less clear. We evaluated the prognostic value of stressful events in patients with initial myocardial infarction (MI) with respect to subsequent cardiovascular events. The KAROLA-study included patients with CHD who participated in an in-patient rehabilitation program. A total of 577 patients with initial MI were included and self-reported psychological stressful events before their MI was assessed by a structured questionnaire. Hazard ratios were used to evaluate the long-term association of stressful events with secondary cardiovascular events. Additionally, associations of stressful events with depression, anxiety and other cardiovascular risk factors were investigated. Unusual stress at work (26.5%) and sleep disorder (23.4%) were the most frequently reported stressful events that occurred in the last 4 weeks before MI. However, only death of a family member showed a statistically significant increase in risk for subsequent cardiovascular events (HR: 1.59; 95%-CI: 1.01–2.50) and this result was not corrected for multiple testing. Notably, we found higher symptom scores of anxiety and depression associated with all single stressful event items. In conclusion, we found no clear patterns that psychological stressful events before MI would increase the long-term risk of subsequent adverse CHD events directly. However, we saw increased symptom scores of anxiety and depression in persons with stressful events. |
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| id | doaj.art-8fbe30cf6f1c4d34978c57b03f9f251b |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T08:43:03Z |
| publishDate | 2021-08-01 |
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| spelling | doaj.art-8fbe30cf6f1c4d34978c57b03f9f251b2023-11-22T08:10:08ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-011016356210.3390/jcm10163562Prevalence and Prognostic Value of Psychological Stress Events in Patients with First Myocardial Infarction—Long-Term Follow-Up StudyAndrea Jaensch0Ben Schöttker1Roman Schmucker2Wolfgang Koenig3Hermann Brenner4Dietrich Rothenbacher5Institute of Epidemiology and Medical Biometry, Ulm University, 89081 Ulm, GermanyDivision of Clinical Epidemiology and Ageing Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, GermanyKlinik Schwabenland, 88316 Isny-Neutrauchburg, GermanyInstitute of Epidemiology and Medical Biometry, Ulm University, 89081 Ulm, GermanyDivision of Clinical Epidemiology and Ageing Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, GermanyInstitute of Epidemiology and Medical Biometry, Ulm University, 89081 Ulm, GermanyWhile there is good evidence that symptoms of depression determine prognosis of patients with coronary heart disease (CHD), the role of psychological stress is less clear. We evaluated the prognostic value of stressful events in patients with initial myocardial infarction (MI) with respect to subsequent cardiovascular events. The KAROLA-study included patients with CHD who participated in an in-patient rehabilitation program. A total of 577 patients with initial MI were included and self-reported psychological stressful events before their MI was assessed by a structured questionnaire. Hazard ratios were used to evaluate the long-term association of stressful events with secondary cardiovascular events. Additionally, associations of stressful events with depression, anxiety and other cardiovascular risk factors were investigated. Unusual stress at work (26.5%) and sleep disorder (23.4%) were the most frequently reported stressful events that occurred in the last 4 weeks before MI. However, only death of a family member showed a statistically significant increase in risk for subsequent cardiovascular events (HR: 1.59; 95%-CI: 1.01–2.50) and this result was not corrected for multiple testing. Notably, we found higher symptom scores of anxiety and depression associated with all single stressful event items. In conclusion, we found no clear patterns that psychological stressful events before MI would increase the long-term risk of subsequent adverse CHD events directly. However, we saw increased symptom scores of anxiety and depression in persons with stressful events.https://www.mdpi.com/2077-0383/10/16/3562coronary heart diseasemyocardial infarctionpsychological stress eventsdepressionanxiety |
| spellingShingle | Andrea Jaensch Ben Schöttker Roman Schmucker Wolfgang Koenig Hermann Brenner Dietrich Rothenbacher Prevalence and Prognostic Value of Psychological Stress Events in Patients with First Myocardial Infarction—Long-Term Follow-Up Study Journal of Clinical Medicine coronary heart disease myocardial infarction psychological stress events depression anxiety |
| title | Prevalence and Prognostic Value of Psychological Stress Events in Patients with First Myocardial Infarction—Long-Term Follow-Up Study |
| title_full | Prevalence and Prognostic Value of Psychological Stress Events in Patients with First Myocardial Infarction—Long-Term Follow-Up Study |
| title_fullStr | Prevalence and Prognostic Value of Psychological Stress Events in Patients with First Myocardial Infarction—Long-Term Follow-Up Study |
| title_full_unstemmed | Prevalence and Prognostic Value of Psychological Stress Events in Patients with First Myocardial Infarction—Long-Term Follow-Up Study |
| title_short | Prevalence and Prognostic Value of Psychological Stress Events in Patients with First Myocardial Infarction—Long-Term Follow-Up Study |
| title_sort | prevalence and prognostic value of psychological stress events in patients with first myocardial infarction long term follow up study |
| topic | coronary heart disease myocardial infarction psychological stress events depression anxiety |
| url | https://www.mdpi.com/2077-0383/10/16/3562 |
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