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Subclinical emotional distress predicts 6-month clinical outcomes after ST-segment elevation myocardial infarction

Olga V Petyunina1, Mykola P Kopytsya2, Alexander E Berezin3

  • 1Senior researcher of department of prevention & treatment of emergency conditions, "LT Malaya Therapy National Institute NAMSU", 2A Liubovi Maloy av., Kharkiv 61039, Ukraine.

Future Cardiology
|June 9, 2020
PubMed

Insights

Subclinical emotional distress in ST-elevation myocardial infarction (STEMI) patients independently predicted adverse 6-month clinical outcomes, including cardiovascular death and re-hospitalization.

Area of Science:

  • Cardiology
  • Psychosomatic Medicine
  • Clinical Outcomes Research

Background:

  • Subclinical emotional distress is prevalent in ST-segment elevation myocardial infarction (STEMI) survivors.
  • The impact of premorbid emotional state on post-STEMI clinical trajectories requires further elucidation.

Purpose of the Study:

  • To examine the association between subclinical emotional distress and 6-month clinical outcomes in patients following STEMI.
  • To identify predictors of adverse events in the 6-month period post-STEMI.

Main Methods:

  • A case-control study design was employed with 144 STEMI patients.
  • The case group (n=72) comprised STEMI patients with subclinical emotional disturbances, while the control group (n=72) consisted of matched STEMI individuals without such disturbances.
  • The primary endpoint was a composite of cardiovascular death, recurrent angina, new heart failure, and re-hospitalization within 6 months.

Main Results:

  • Subclinical emotional distress was a significant independent predictor of the composite 6-month adverse outcome (OR = 2.48; 95% CI: 1.12-5.33; p = 0.034).
  • Additional independent predictors included Type 2 diabetes mellitus (OR = 1.10; 95% CI: 1.02-1.23; p = 0.048), a Thrombolysis in Myocardial Infarction (TIMI) score < 6 (OR = 0.86; 95% CI: 0.67-0.92; p = 0.001), and the number of culprit vessels (OR = 1.19; 95% CI: 1.02-1.34; p = 0.002).

Conclusions:

  • Premorbid emotional distress independently predicts adverse 6-month clinical outcomes in patients who have experienced STEMI.
  • These findings underscore the importance of addressing psychological factors in the management of STEMI patients to improve long-term prognoses.

Keywords:
STEMIanxietyclinical outcomesdepressionemotional distresspercutaneous coronary interventionstress

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