Highest psychosocial distress was associated with a 4.0-point higher summed rest score compared to lowest distress in women (95% CI 0.2-7.7), but not in men (P=0.04 for interaction).
Cross-Sectional (n=665)
Does higher psychosocial distress associate with mental stress-induced myocardial ischemia or resting perfusion abnormalities in patients with stable CAD?
Higher psychosocial distress is associated with more resting myocardial perfusion abnormalities in women with stable CAD, but not with mental stress-induced ischemia in either sex.
Mean Difference: 4 (95% CI 0.2–7.7)
p-value: p=.04
OBJECTIVE: Mental stress-induced myocardial ischemia is a frequent phenomenon in patients with coronary artery disease (CAD). The link between an integrated measure of chronic psychosocial distress and mental stress-induced myocardial ischemia, and whether it differs by sex, has not been examined before. METHODS: We used latent class analysis to derive a composite measure of psychosocial distress integrating scales of depression, posttraumatic stress, anxiety, anger, hostility, and perceived stress in 665 individuals with stable CAD. Participants underwent myocardial perfusion imaging with mental stress and perfusion defects were quantified at rest (summed rest score), with mental stress (summed stress score), and their difference (summed difference score), the latter being an index of inducible ischemia. RESULTS: The M (SD) age was 63 (9) years, and 185 (28%) were women. Latent class analysis characterized the study sample into four distinct classes of incremental psychosocial distress. In women, class 4 (highest distress) had an adjusted 4.0-point higher summed rest score (95% confidence interval = 0.2-7.7) as compared with class 1 (lowest distress), whereas no difference was observed in men (-0.87 points, 95% confidence interval = -3.74 to 1.99, p = .04 for interaction). There was no association between the psychosocial distress latent variable and summed difference score in either women or men. CONCLUSIONS: Among patients with CAD, a higher level of psychosocial distress is not associated with mental stress ischemia, but it is associated with more resting (fixed) perfusion abnormalities in women only, as well as with blunted hemodynamic response to mental stress in both men and women.
Pimple et al. (Mon,) conducted a cross-sectional in stable coronary artery disease (CAD) (n=665). High psychosocial distress (class 4) vs. Lowest psychosocial distress (class 1) was evaluated on Summed rest score and summed difference score (MD 4.0, 95% CI 0.2-7.7, p=.04). Highest psychosocial distress was associated with a 4.0-point higher summed rest score compared to lowest distress in women (95% CI 0.2-7.7), but not in men (P=0.04 for interaction).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: