Association of depression and stress in acute myocardial infarction: a case-control study

Background: Psychosocial factors have been reported to be independently associated with coronary artery disease (CAD). However, the stress variable is still sub detailed and there are few studies that used coronary angiography (CA) to assess CAD. Objectives: To compare levels of depression, stress...

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Main Authors: Patricia RM Goldfeld, Luciana S Soares, Waldomiro C Manfroi
Format: Article
Language:English
Published: Universidad Nacional de Colombia 2015-07-01
Series:Revista de la Facultad de Medicina
Subjects:
Online Access:https://revistas.unal.edu.co/index.php/revfacmed/article/view/50860
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author Patricia RM Goldfeld
Luciana S Soares
Waldomiro C Manfroi
author_facet Patricia RM Goldfeld
Luciana S Soares
Waldomiro C Manfroi
author_sort Patricia RM Goldfeld
collection DOAJ
description Background: Psychosocial factors have been reported to be independently associated with coronary artery disease (CAD). However, the stress variable is still sub detailed and there are few studies that used coronary angiography (CA) to assess CAD. Objectives: To compare levels of depression, stress and stressful life events in three groups of individuals: post-MI (Myocardial Infarction) patients; patients presenting symptoms and no previous MI, who underwent cardiac catheterization and had non-significant obstructive CAD and individuals with no symptoms of cardiac disease or others diseases. Methods: We conducted a case-control study, with two cases groups and one control group. The study included 105 patients with recent Myocardial Infarction (MI group), 101 patients with cardiac symptoms and normal CA (CS group), and 100 patients without symptoms of disease (NS group). Multivariate logistic regression was used to assess, stress and vital events, with an Odds Ratio of 95% confidence interval (CI), controlling for age, sex, education level, income, social support group, Body Mass Index (BMI), sedentary lifestyle and family history of MI or sudden death. Results: MI patients group showed depression with an OR= 4.47(95% CI, 2:36 to 8:46, p<.001), and stress OR= 5.37(95%CI, 2.94-9.78, p <.001) whereas CS group showed depression: OR= 6.95(95%CI, 3.64-13.28, p <.001) and stress: OR = 9.18 (95%CI, 4.73-17.82, p <.001) compared to patients without symptoms. After adjusting for risk factors: age, sex, education, income, social support, obesity, sedentary lifestyle, family history of MI or sudden death, the OR showed the following variation: in the MI group, depression OR= 2.51 (95%CI, 1:05 to 5:98, p = .038), stress, OR= 8.76(95%CI, 3:48 to 22:01, p <.001), and CS group, depression OR= 3.25(95%CI, 1.40-7.55,p <01) and stress OR= 12.24 (95%,      CI, 4.81-31.14, p <.001). The raised effect of variable stress after adjustment was promoted by the age, sex and physical inactivity variables, and did not affect the significance level (p <.001). Conclusions: This study has demonstrated that subjects with cardiac symptoms without overt CAD, present similar depression and/or stress levels than post-MI patients. And also, post-MI patients and CS patients have more stress and depression than controls, even when adjusted for age, sex, education level, family income, social support, obesity, sedentary lifestyle and family history of MI and / or sudden death.
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spelling doaj.art-fc43a6b5839f4056b612b82a4c825cca2022-12-21T17:30:42ZengUniversidad Nacional de ColombiaRevista de la Facultad de Medicina0120-00112357-38482015-07-0163343944810.15446/revfacmed.v63n3.5086040872Association of depression and stress in acute myocardial infarction: a case-control studyPatricia RM Goldfeld0Luciana S Soares1Waldomiro C Manfroi2Department of Cardiology, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.Scholarship of Scientific Initiation, Department of Cardiology, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.Department of Cardiology. Medical School, Universidade Federal do Rio Grande do Sul. Porto Alegre, Brazil.Background: Psychosocial factors have been reported to be independently associated with coronary artery disease (CAD). However, the stress variable is still sub detailed and there are few studies that used coronary angiography (CA) to assess CAD. Objectives: To compare levels of depression, stress and stressful life events in three groups of individuals: post-MI (Myocardial Infarction) patients; patients presenting symptoms and no previous MI, who underwent cardiac catheterization and had non-significant obstructive CAD and individuals with no symptoms of cardiac disease or others diseases. Methods: We conducted a case-control study, with two cases groups and one control group. The study included 105 patients with recent Myocardial Infarction (MI group), 101 patients with cardiac symptoms and normal CA (CS group), and 100 patients without symptoms of disease (NS group). Multivariate logistic regression was used to assess, stress and vital events, with an Odds Ratio of 95% confidence interval (CI), controlling for age, sex, education level, income, social support group, Body Mass Index (BMI), sedentary lifestyle and family history of MI or sudden death. Results: MI patients group showed depression with an OR= 4.47(95% CI, 2:36 to 8:46, p<.001), and stress OR= 5.37(95%CI, 2.94-9.78, p <.001) whereas CS group showed depression: OR= 6.95(95%CI, 3.64-13.28, p <.001) and stress: OR = 9.18 (95%CI, 4.73-17.82, p <.001) compared to patients without symptoms. After adjusting for risk factors: age, sex, education, income, social support, obesity, sedentary lifestyle, family history of MI or sudden death, the OR showed the following variation: in the MI group, depression OR= 2.51 (95%CI, 1:05 to 5:98, p = .038), stress, OR= 8.76(95%CI, 3:48 to 22:01, p <.001), and CS group, depression OR= 3.25(95%CI, 1.40-7.55,p <01) and stress OR= 12.24 (95%,      CI, 4.81-31.14, p <.001). The raised effect of variable stress after adjustment was promoted by the age, sex and physical inactivity variables, and did not affect the significance level (p <.001). Conclusions: This study has demonstrated that subjects with cardiac symptoms without overt CAD, present similar depression and/or stress levels than post-MI patients. And also, post-MI patients and CS patients have more stress and depression than controls, even when adjusted for age, sex, education level, family income, social support, obesity, sedentary lifestyle and family history of MI and / or sudden death.https://revistas.unal.edu.co/index.php/revfacmed/article/view/50860DepressionStressVital EventsMyocardial InfarctionCardiovascular DiseaseRisk FactorsEpidemiology.
spellingShingle Patricia RM Goldfeld
Luciana S Soares
Waldomiro C Manfroi
Association of depression and stress in acute myocardial infarction: a case-control study
Revista de la Facultad de Medicina
Depression
Stress
Vital Events
Myocardial Infarction
Cardiovascular Disease
Risk Factors
Epidemiology.
title Association of depression and stress in acute myocardial infarction: a case-control study
title_full Association of depression and stress in acute myocardial infarction: a case-control study
title_fullStr Association of depression and stress in acute myocardial infarction: a case-control study
title_full_unstemmed Association of depression and stress in acute myocardial infarction: a case-control study
title_short Association of depression and stress in acute myocardial infarction: a case-control study
title_sort association of depression and stress in acute myocardial infarction a case control study
topic Depression
Stress
Vital Events
Myocardial Infarction
Cardiovascular Disease
Risk Factors
Epidemiology.
url https://revistas.unal.edu.co/index.php/revfacmed/article/view/50860
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AT waldomirocmanfroi associationofdepressionandstressinacutemyocardialinfarctionacasecontrolstudy