Psychosocial characteristics and recurrent events after percutaneous transluminal coronary angioplasty

Leon, Carlos F. Mendes de; Kop, Willem J.; Swart, Hans de; Bär, Frits W.; Appels, Ad

doi:10.1016/s0002-9149(97)89388-5

Cited by 83 publications

(44 citation statements)

References 28 publications

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“…16 We now show, for the first time, that fatigue is also an important predictor for death late after stroke, even after adjustment for depression and other important predictors of survival. It has previously been shown that vital exhaustion, a syndrome of unusual fatigue and loss of energy, increased irritability, and depressive symptoms, increases risk of acute myocardial infarction and other manifestations of coronary heart disease [22][23][24] Fatigue in association with other diseases and conditions is treated many different ways, including cognitive behavioral therapy, hydrocortisone, diaminopyrimidine, and psychotropic drugs. 14,[25][26][27] However, in different diseases or medical conditions, different mechanisms probably cause the fatigue, and specific treatments are needed.…”

Section: Discussionmentioning

confidence: 99%

Poststroke Fatigue

Glader

Stegmayr

Asplund

2002

Stroke

374

222

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Background and Purpose-Fatigue is common among stroke patients. This study determined the prevalence of fatigue among long-term survivors after stroke and what impact fatigue had on various aspects of daily life and on survival. Methods-This study was based on Riks-Stroke, a hospital-based national register for quality assessment of acute stroke events in Sweden. During the first 6 months of 1997, 8194 patients were registered in Riks-Stroke, and 5189 were still alive 2 years after the stroke. They were followed up by a mail questionnaire, to which 4023 (79%) responded. Patients who reported that they always felt depressed were excluded. Results-To the question, "Do you feel tired?" 366 (10.0%) of the patients answered that they always felt tired, and an additional 1070 (29.2%) were often tired. Patients who always felt tired were on average older than the rest of the study population (74.5 versus 71.5 years, PϽ0.001); therefore, all subsequent analyses were age adjusted. Fatigue was an independent predictor for having to move into an institutional setting after stroke. Fatigue was also an independent predictor for being dependent in primary activities of daily living functions. Three years after stroke, patients with fatigue also had a higher case fatality rate. Conclusions-Fatigue is frequent and often severe, even late after stroke. It is associated with profound deterioration of several aspects of everyday life and with higher case fatality, but it usually receives little attention by healthcare professionals. Intervention studies are needed.

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Section: Discussionmentioning

confidence: 99%

Poststroke Fatigue

Glader

Stegmayr

Asplund

2002

Stroke

374

222

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“…Anger has been shown to differ among SES groups [16] and to predict prognosis in CHD [55]. We believe our study is the first to examine it as a potential intermediate factor for the social differences in CHD.…”

Section: Chd Risk Factors As Explanatory Factors For the Social Gradimentioning

confidence: 78%

Income and recurrent events after a coronary event in women

2008

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Strong evidence supports the existence of a social gradient in poor prognosis in patients with coronary heart disease (CHD). However, knowledge regarding what factors may explain this relationship is limited. We aimed to analyze in women CHD patients the association between personal income and recurrent events and to determine whether lifestyle, biological and psychosocial factors contribute to the explanation of this relationship. Altogether 188 women hospitalized for a cardiac event were assessed for personal income, demographic factors, lipids, inflammatory markers, cortisol, creatinine, lifestyle and psychosocial factors, i.e. alcohol consumption, smoking habits, body-mass index, depressive symptoms, anxiety, vital exhaustion, availability of social interaction, hostility and anger-related characteristics and were followed for cardiovascular death and recurrent acute myocardial infarction (AMI). During the 6-year follow-up 18 patients deceased and 31 experienced cardiovascular death or nonfatal AMI. After adjustment for confounders, patients with medium and high income had lower risk for recurrent events relative to those with low income (HR (95% CI): 0.38 (0.15-0.97) and 0.39 (0.17-0.93), respectively). Controlling for smoking reduced by 12.8% the risk for recurrent events associated with high versus low income, while adjusting for depression decreased the risk for middle versus low income by 13.5%. Anger symptoms explained 16.7% of the risk for recurrent events associated with middle versus low income and 10.2% of the risk for high versus low income. We suggest that in women with CHD low income is associated with recurrent events and that smoking, depressive symptomatology and anger symptoms may contribute to the explanation of this relationship.

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“…Other investigators have suggested a variety of psychological risk factors in coronary patients, including, negative affect [6], anxiety [17], anger [18], stress [19], and vital exhaustion [11]. Previous research showed that Type D may be a major determinant of negative affect, anxiety, anger, and stress [12].…”

mentioning

confidence: 99%