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Psychological correlates of progression of atherosclerosis in men
Insights
Patients with severe coronary artery disease showed progression, especially those with Type A behavior. Extreme Type B behavior may protect against disease progression over time.
Area of Science:
- Cardiology
- Behavioral Science
Background:
- Coronary artery disease (CAD) is a leading cause of mortality.
- Understanding factors influencing CAD progression is crucial for patient management.
Purpose of the Study:
- To investigate the relationship between Type A behavior and the progression of coronary artery disease.
- To identify predictors of CAD progression in patients undergoing serial coronary angiograms.
Main Methods:
- Patients (n=66) with prior coronary angiograms completed the Jenkins Activity Survey.
- A subset (n=45) underwent the Rosenman diagnostic interview for Type A behavior assessment.
- Coronary artery disease progression was defined as ≥25% increase in occlusion or new total occlusion.
Main Results:
- 30% of patients demonstrated CAD progression over an average of 17 months.
- Progression was associated with initially more severe disease and marginally with smoking.
- Jenkins Activity Survey Type A scores positively correlated with disease progression.
Conclusions:
- Jenkins Activity Survey Type A scores, not interview-based assessment, showed a link to CAD progression.
- Extreme Type B behavior may be associated with a lower likelihood of disease progression.
Abstract:
Patients who underwent repetitive repetitive coronary angiograms at an average interval of 17 months completed the Jenkins Activity Survey (n = 66) and were given the Rosenman diagnostic interview to measure Type A behavior (n = 45). Significant progression of coronary artery disease was judged to be an increase in occlusion of 25% or more, or progression to total occlusion in any vessel. At subsequent study, 30% of the patients showed evidence of progression. Progression was much more likely in patients with initially more severe disease and was marginally related to cigarette smoking when initial level of disease was controlled. Interview assessment of Type A did not discriminate reliably between the groups in the smaller sample of patients given this measure. There was significant positive association between magnitude of Activity Survey Type A scores and progression of disease, although mean scores on the Type A scale were not reliably different between the Progression and No Progression groups. The pattern of results suggested that extreme Type B subjects (classified by Activity Survey) were unlikely to show progression over this time period.