Turk Kardiyol Dern Ars. Ahead of Print: TKDA-30020 | DOI: 10.5543/tkda.2020.30020
Perceived stress level is associated with coronary artery disease severity in patients with ST segment elevation myocardial infarction
, Fatma Cam Kahraman2
, Hicaz Zencirkiran Agus1
, Ali Kemal Kalkan1
, Fatih Uzun1
, Muammer Karakayalı1
, Mehmet altunova1
, Samet Sevnc1
, Ali Riza Demir1
, Emre Yilmaz1
, Mehmet Erturk11
University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Department of Cardiology, Istanbul, TURKEY2
Istanbul Bilim University, Faculty of Arts and Sciences, Department of Psychology, Istanbul, Turkey
OBJECTIVE Stress is known as a significant risk factor for coronary atherosclerosis and adverse cardiovascular events. However, the stress-related coronary atherosclerotic burden has not been investigated yet. In our study, we aimed to investigate the relationship between perceived stress scale (PSS) and Syntax scores in patients with ST segment elevation myocardial infarction (STEMI).
METHODS Four hundred forty patients with STEMI were prospectively enrolled and divided into two groups according to their PSS levels with a cut-off value of 17.5 by using ROC curve analysis. 361 patients with low PSS level were categorized as group 1 and 79 patients with high PSS level were categorized as group 2.
RESULTS Syntax score [16.0 (10.0-22.5); 22.5 (15.0-25.5), p<0.001] and Syntax score II [24.8 (19.0-32.6); 30.9 (22.3-38.9), p<0.001] were significantly higher in group 2. Spearman analysis demonstrated that PSS was related with Syntax score (r=0.153, p=0.001) and Syntax score II (r=0.216, p<0.001). Additionally, PSS (OR: 2.434, CI: 1.446-4.096, p=0.001) was found as an independent predictor of moderate to high Syntax score. PSS score of patients with in-hospital mortality was also higher than those without mortality [15 (10-20); 9 (4-16), p=0.007].
CONCLUSION Stress seems to accelerate coronary atherosclerotic process and burden. The increased stress level was also found to be an independent predictor of high Syntax score.
coronary artery disease, perceived stress scale, ST-segment elevation myocardial infarction, Syntax score
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Corresponding Author: Serkan Kahraman, Türkiye