Key result
Higher anxiety symptoms and the presence of Type D personality were significantly associated with a blunted cortisol response during psychosocial stress in patients with recent acute coronary syndrome.
Why the study?
The relationship between cortisol response to psychosocial stress, mental distress, fatigue, and HRQoL in CAD patients after recent ACS remained to be explored.
Is mental distress, fatigue, or health-related quality of life associated with altered cortisol response to psychosocial stress in patients with recent acute coronary syndrome?
Cross-Sectional (n=113)
No
Is mental distress, fatigue, or health-related quality of life associated with altered cortisol response to psychosocial stress in patients with recent acute coronary syndrome?
Effect estimate: β = -0.224 for anxiety symptoms; β = -0.290 for Type D personality
p-value: p=0.035 and 0.006
In patients with recent acute coronary syndrome, mental distress (anxiety and Type D personality) is associated with a blunted cortisol response to acute psychosocial stress.
Does not support practice changes in recent ACS; leaves open whether distress-targeted interventions affect HPA recovery.
We aimed to explore the relationship between cortisol response to psychosocial stress, mental distress, fatigue and HRQoL in individuals with coronary artery disease (CAD) after recent acute coronary syndrome (ACS). A cross-sectional study initially included 113 subjects (88% men, 53 ± 7 years) 1–3 weeks after ACS. Cortisol response was assessed by measuring salivary cortisol during Trier Social Stress Test. Mental distress was measured with Hospital Anxiety and Depression Scale, State-Trait Anxiety Inventory, and Type D Scale-14. Fatigue symptoms were evaluated using Multidimensional Fatigue Inventory 20-items, while Health related quality of life (HRQoL) was assessed with 36-Item Short Form Medical Outcome Questionnaire. After conducting multivariable linear regression analyses, diminished cortisol response during public speech was significantly associated with higher anxiety symptoms (β=-0.224; p = 0.035), while diminished cortisol response during pre-task preparation was significantly linked with the presence of Type D personality (β=-0.290; p = 0.006; β=-0.282; p = 0.008 respectively), even after controlling for confounders (i.e., sex, age, education, NYHA functional class, beta-blockers and baseline levels of cortisol measures). We found that mental distress, but not fatigue and HRQoL, was linked with blunted cortisol response during psychosocial stress, independently of potential covariates.
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Gečaitė-Stončienė et al. (2022) conducted a cross-sectional in Coronary artery disease after acute coronary syndrome (n=113). Mental distress (anxiety symptoms and Type D personality) vs. Lower mental distress / absence of Type D personality was evaluated on Cortisol response during Trier Social Stress Test (β = -0.224 for anxiety symptoms; β = -0.290 for Type D personality, p=0.035 and 0.006). Higher anxiety symptoms and the presence of Type D personality were significantly associated with a blunted cortisol response during psychosocial stress in patients with recent acute coronary syndrome.
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