Acute myocardial infarction preceded by potential triggering activities: Angiographic and clinical characteristics

Brodov, Yafim; Sandach, Amir; Boyko, Valentina; Matetzky, Shlomi; Guetta, Victor; Mandelzweig, Lori; Behar, Solomon

doi:10.1016/j.ijcard.2007.07.173

Cited by 6 publications

(4 citation statements)

References 28 publications

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“…Therefore, these findings may not reflect acute distress levels immediately prior to MI onset and may at least partially reflect sustained distress in addition to acute distress. In another study of 662 MI patients no association was found between acute physical or emotional precipitants of MI and mortality during one year follow-up 13 . It is possible that this study was underpowered as a result of the relatively limited number of events during follow-up.…”

Section: Discussionmentioning

confidence: 87%

“…In addition to the consistent evidence of an immediately higher cardiovascular risk associated with short-term experiences of negative emotions, the long-term prognosis may be poor among people surviving an MI following these potential acute triggers 12 . However, other studies have not found an association between acute emotional precipitants of MI and long-term mortality 13 . Clinical characteristics of patients whose MI is preceded by negative emotions may partly account for these observed differences in long-term prognosis.…”

Section: Introductionmentioning

confidence: 85%

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Anxiety and anger immediately prior to myocardial infarction and long-term mortality: Characteristics of high-risk patients

Smeijers

Mostofsky

Tofler

et al. 2017

Journal of Psychosomatic Research

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Objective Acute high levels of anger and anxiety are associated with an elevated risk of myocardial infarction (MI) in the following two hours. MIs preceded by these acute negative emotions may also have a poor long-term prognosis, but information about high-risk patients is lacking. We examined whether young age and female sex are associated with MIs that are preceded by negative emotions and whether age and sex moderate the subsequent increased mortality risk following MI preceded by negative emotions. Methods We conducted a secondary analysis of the Determinants of Myocardial Infarction Onset Study (N=2176, mean age=60.1±12.3 years, 29.2% women). Anxiety and anger immediately prior to (0-2 hour) MI and the day before (24-26 hour) MI were assessed using a structured interview. Subsequent 10-year all-cause mortality was determined using the US National Death Index. Results Anxiety during the 0-2 hour pre-MI period was associated with younger age (OR=0.98,95%CI=0.96-0.99 per year) and female sex (OR=1.50,95%CI=1.11-2.02). Anger in the 0-2 hour pre-MI period was also associated with younger age (OR=0.95,95%CI=0.94-0.96) but not with sex (OR=0.93,95%CI=0.67-1.28). During follow-up, 580 (26.7%) patients died. Mortality rate was higher if MI occurred immediately after high anxiety, particularly in patients ≥65 years (HR=1.80,95%CI=1.28-2.54) vs. younger patients (HR=0.87,95%CI=0.55-1.40; p-interaction=0.015). Other interactions with sex or anger were not significant. Conclusions Patients with high anxiety or anger levels in the critical 2-hour period prior to MI are younger than those without such emotional precipitants. In addition, pre-MI anxiety is associated with an elevated 10-year mortality risk in patients aged ≥65 years.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 85%

Anxiety and anger immediately prior to myocardial infarction and long-term mortality: Characteristics of high-risk patients

Smeijers

Mostofsky

Tofler

et al. 2017

Journal of Psychosomatic Research

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 95%

“…Some previous investigations described clinical and angiographic characteristics of exercise-related ACS and SCD [ 5,19,20,22,29], but to our knowledge, this is the first OCT study in this particular subgroup of sport-triggered ACS and SCD patients with nonsignificant stenosis on angiography. e individuals of our study were predominantly middle-aged men with low cardiovascular risk burden in agreement with prior studies [5,15,19,20,30].…”

Section: Discussionmentioning

confidence: 98%

Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary Angiography

Mas-Lladó

Maristany

Gómez-Lara

et al. 2020

Journal of Interventional Cardiology

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Objectives. The aim of this study is to assess the utility of optical coherence tomography (OCT) in patients with exercise-related acute coronary syndrome (ACS) presenting with inconclusive angiographic findings. Background. Regular physical activity reduces the incidence of cardiovascular events. Nevertheless, the risk of ACS or sudden cardiac death (SCD) increases during sport. In adults older than 35 years, exercise-related ACS or SCD is associated with plaque rupture, but not infrequently patients present ambiguous angiographic findings. Methods. Between September 2015 and January 2020, patients admitted for ACS or SCD triggered by physical exertion and with coronary stenosis ≤50% were included in this prospective observational study. OCT was performed on the artery deemed to be responsible of the event. Results. Ten patients were enrolled, predominantly men (80%) of middle age (51 years old, IQR 41–63) with low cardiovascular risk burden. Cycling was the most frequent (50%) exercise-related trigger, 8 patients were regular sport practitioners, and 7 had the clinical event during strenuous exertion. Five patients presented with non-ST-elevation ACS, two with ST-elevation ACS, and three with SCD. Angiographic analysis showed nonsignificant stenosis in all patients (42% stenosis, IQR 36–46). OCT identified the etiology of the event in 9 patients (4 plaque erosion, 3 plaque rupture, 1 eruptive calcific nodule, and 1 coronary dissection). Treatment was adjusted according to OCT findings. Conclusions. OCT is a valuable technique to identify the etiology of exercise-related ACS or SCD in patients with nonobstructive coronary arteries and, as a result, may lead to a more specific treatment.

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The Interaction Between Psychologic Distress and Biobehavioral Processes in Cardiovascular Disease

Kop

Gottdiener

2011

Psychiatry and Heart Disease

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Acute myocardial infarction preceded by potential triggering activities: Angiographic and clinical characteristics

Cited by 6 publications

References 28 publications

Anxiety and anger immediately prior to myocardial infarction and long-term mortality: Characteristics of high-risk patients

Anxiety and anger immediately prior to myocardial infarction and long-term mortality: Characteristics of high-risk patients

Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary Angiography

The Interaction Between Psychologic Distress and Biobehavioral Processes in Cardiovascular Disease

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