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Psychological and clinical characteristics of patients with spontaneous coronary artery dissection: A case-control study
Smaardijk,V.R. Mommersteeg,P.M.C. Kop,W.J. Pellegrini,D. van Geuns,R.J. Maas,A.H.E.M.
Smaardijk,V.R.
Mommersteeg,P.M.C.
Kop,W.J.
Pellegrini,D.
van Geuns,R.J.
Maas,A.H.E.M.
Abstract
Background The relative frequency of psychological factors in patients with spontaneous coronary artery dissection (SCAD) compared to patients with traditional atherosclerosis-related type 1 acute coronary syndrome (ACS) is unknown. This study examines whether psychological factors and emotional or physical precipitants are more common in SCAD patients versus atherosclerosis-related ACS patients. Methods Participants with SCAD were recruited from a Dutch SCAD database. Given the predominance of SCAD in women (>90%), only female patients were included. The age- and sex-matched atherosclerosis-related ACS group was identified from a registry database. Online questionnaires and medical records were used to investigate psychological factors and clinical information. Univariate and multivariate logistic regression models were used to examine differences between 172 SCAD patients and 76 ACS patients on emotional and physical precipitants prior to the event and psychological factors after the event. Results Patients with SCAD were more likely to experience an emotional precipitant in the 24 h prior to the event (56%), compared with the ACS group (39%) (OR = 1.98, 95%CI 1.14-3.44). Multivariate analyses showed that this association remained significant after adjustment for covariates (OR = 2.17, 95%CI 1.08-4.36). At an average of 3.2 years post-hospitalization for the SCAD or atherosclerosis-related ACS event, both patient groups had similar high levels of perceived stress (50% vs. 45%, p = .471) and fatigue (56% vs. 53%, p = .643). Conclusions This study shows that risk profiles for SCAD differ from traditional atherosclerosis-related ACS. Our findings may help health professionals to recognize SCAD and offer tailored rehabilitation and prevention programs.
Description
Funding This work was supported by research fund ‘Hart voor Vrouwen’, Radboudumc (Nijmegen, The Netherlands).
Date
2021
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Research Projects
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Keywords
ACUTE MYOCARDIAL-INFARCTION, ASSOCIATION, Acute coronary syndrome (ACS), CARDIAC REHABILITATION PROGRAM, FATIGUE, Psychological factors, Risk factors, SCAD, Spontaneous coronary artery dissection (SCAD), Stress, Women, SDG 3 - Good Health and Well-being
Citation
Smaardijk, V R, Mommersteeg, P M C, Kop, W J, Pellegrini, D, van Geuns, R J & Maas, A H E M 2021, 'Psychological and clinical characteristics of patients with spontaneous coronary artery dissection : A case-control study', International Journal of Cardiology, vol. 323, pp. 1-6. https://doi.org/10.1016/j.ijcard.2020.08.045