Abstract P063: Defects in Well-Being Psychological Factors Rather Than Ill-Being Factors Are Predictors of Acute Coronary Syndrome: A Comprehensive Lifestyle Analysis

Abstract

Introduction: An increasing body of evidence suggests that development of coronary artery disease (CAD) is probably affected by a variety of lifestyle factors. However, most studies have not assessed comprehensive lifestyle factors including well-being psychological factors simultaneously, therefore relative contribution of each factors is obscure. Hypothesis: A variety of lifestyle factors including defect in well-being psychological factors may contribute to development of CAD through interacting muturally. Methods and Results: A case-control, cross-sectional study analyzing comprehensive lifestyle factors of patients with acute coronary syndrome (ACS) and healthy control was conducted. 92 patients with ACS (73 male; 53.2 yr; 30 acute MI, 62 unstable angina) and 69 healthy control (43 male; 48.7yr) were recruited. For dietary analysis, food frequency questionnaire (FFQ) and 2 days of 24 hour dietary recall were used. Anxiety, depression, stress, job stress, and hostility were analyzed to assess psychological ill-being factors. Primary and secondary control strategies, health-related quality of life (HRQoL), and satisfaction degree in 7 life domains such as marriage, leisure, standard of living, job, family, sex life, and self were analyzed to assess well-being factors. Univariate analysis showed that ACS group vs. control group had more current/ex-smoker and exercised less (all, p<0.05). FFQ analysis showed that ACS group vs. control consumed more energy intake, fats, proteins, seafoods, and sweets (all, p<0.05). Psychological analysis showed that the ACS group had more depressive score, less mean satisfaction score in all 7 life domains, and less physical domain of HRQoL especially in the fields of 1) general health perceptrion and 2) bodily pain (all p<0.05). The ACS group vs. control tended to use more primary control strategy, although not reaching statistical signifcance. Logistic regression analysis, after adjustment of age and gender, identified that mean satisfaction score in 7 life domains (OR: 9.66), primary control strategy (OR: 1.92), greater intake of sea foods (OR 6.53) and sweets (OR: 7.40), exercise (OR: 0.26), and smoking (OR:7.53) were determined as significant independent predictors of ACS (all, p<0.05). Conclusions: Defects in well-being psychological factors rather than ill-being factors are closely associated with ACS. A variety of lifestyle factors, especially, poor satisfaction in 7 life domains, use of primary control strategy, greater intake of sea foods and sweets, smoking, and poor exercise are independent predictors of ACS. Therefore preventive intervention trial of ACS should include modification of comprehensive lifestyle factors including defects in well-being factors.