Key result
Moderate or severe perceived stress in patients with AMI was not significantly associated with an increased risk of 30-day MACE compared to low stress (2.1% vs 1.04%; P=0.42).
Why the study?
Psychosocial stress has been implicated as a risk factor for cardiovascular diseases, but little evidence exists regarding the prevalence of stress among patients with AMI.
Does moderate or severe perceived stress increase the risk of major adverse cardiac events at 1 month in patients presenting with acute myocardial infarction?
Cohort (n=903)
No
Does moderate or severe perceived stress increase the risk of major adverse cardiac events at 1 month in patients presenting with acute myocardial infarction?
Absolute Event Rate: 2.1% vs 1.04%
p-value: p=0.42
There is a high prevalence of severe and moderate perceived stress among Indian patients presenting with AMI, though it was not associated with a statistically significant increase in 30-day MACE.
High perceived stress common in AMI; leaves open whether screening or intervention improves outcomes.
BACKGROUND: Psychosocial factors such as stress have been previously implicated as a risk factor for cardiovascular diseases (CVDs). There is little evidence regarding the prevalence of stress among patients with acute myocardial infarction (AMI). METHODS: A total of 903 patients with AMI enrolled in the North Indian ST-Segment Elevation Myocardial Infarction (NORIN-STEMI) registry were included in this study. Perceived stress in these subjects was evaluated using the Perceived Stress Scale-10 questionnaire while the World health Organization (WHO-5) Well-being Index was used to evaluate psychological well-being. All these patients were followed up for one month and major adverse cardiac events (MACE) were determined. RESULTS: A majority of patients with AMI had either severe (478 [52.9%]) or moderate stress (347 [38.4%]) while low stress levels were observed in 78 [8.6%] patients. Additionally, most of the patients with AMI (478 [53%]) had WHO-5 well-being index <50%. Subjects with severe stress were younger (50.86 ± 13.31; P < 0.0001), more likely to be males (403 [84.30%]; P = 0.027), were less likely to have optimal level of physical activity (P < 0.0001) and had lower WHO-5 well-being score (45.54 ± 1.94%; P < 0.0001) as compared to those with low and moderate stress levels. On 30-days follow-up, subjects with moderate/severe stress had higher MACE however, the difference was non-significant (2.1% vs 1.04%; P = 0.42). CONCLUSION: A high prevalence of perceived stress and low well-being index was observed in patients presenting with AMI in India.
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Gupta et al. (2023) conducted a cohort in Acute myocardial infarction (n=903). Moderate or severe perceived stress vs. Low perceived stress was evaluated on Major adverse cardiac events (MACE) (p=0.42). Moderate or severe perceived stress in patients with AMI was not significantly associated with an increased risk of 30-day MACE compared to low stress (2.1% vs 1.04%; P=0.42).
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