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时间紧迫性与非致命性心肌梗死风险

Time urgency and risk of non-fatal myocardial infarction.

作者信息

Cole S R, Kawachi I, Liu S, Gaziano J M, Manson J E, Buring J E, Hennekens C H

机构信息

Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA02215, USA.

出版信息

Int J Epidemiol. 2001 Apr;30(2):363-9. doi: 10.1093/ije/30.2.363.

Abstract

BACKGROUND

Inconsistencies in the literature linking Type A behaviour pattern (TAB) to coronary heart disease (CHD) may be due to differences in the effects of various components of TAB, namely aggressiveness, hostility, ambitiousness, competitive drive, and a chronic sense of time urgency.

METHODS

We investigated the association between sense of time urgency/impatience and non-fatal myocardial infarction (MI) in a study of 340 cases and an equal number of age-, sex-, and community-matched controls.

RESULTS

A dose-response relation was apparent among subjects who rated themselves higher on the four-item time urgency/impatience scale (P-value for trend <0.001), with a matched odds ratio (OR) for non-fatal MI of 4.45 (95% CI : 2.20-8.99) comparing those with the highest rating to those with the lowest. After further adjustment for family history of premature MI, physical activity, body mass index, occupation, cigarette smoking, total caloric intake, per cent calories from saturated fat, alcohol intake, lipid levels, treated hypertension and diabetes, the dose-response relation remained (P-value for trend = 0.015) and the adjusted OR for MI was 3.99 (95% CI : 1.32-12.0) comparing those with the highest rating to those with the lowest.

CONCLUSION

In these data, a sense of time urgency/impatience was associated with a dose-response increase in risk of non-fatal MI, independent of other risk factors. Prospective cohort studies of time urgency/impatience and incident CHD events are needed to confirm or refute these observations from a case-control study.

摘要

背景

文献中关于A型行为模式(TAB)与冠心病(CHD)之间的联系存在不一致,这可能是由于TAB各组成部分(即攻击性、敌意、野心、竞争驱力和长期的时间紧迫感)的影响存在差异。

方法

在一项研究中,我们调查了340例非致命性心肌梗死(MI)患者以及数量相等、年龄、性别和社区匹配的对照组中时间紧迫感/不耐烦与非致命性MI之间的关联。

结果

在四项时间紧迫感/不耐烦量表上自我评分较高的受试者中,存在明显的剂量反应关系(趋势P值<0.001),将评分最高者与最低者相比,非致命性MI的匹配比值比(OR)为4.45(95%CI:2.20 - 8.99)。在进一步调整过早发生MI的家族史、体力活动、体重指数、职业、吸烟、总热量摄入、饱和脂肪热量百分比、酒精摄入、血脂水平、治疗过的高血压和糖尿病后,剂量反应关系仍然存在(趋势P值 = 0.015),将评分最高者与最低者相比,MI的调整后OR为3.99(95%CI:1.32 - 12.0)。

结论

在这些数据中,时间紧迫感/不耐烦与非致命性MI风险的剂量反应性增加相关,且独立于其他风险因素。需要进行关于时间紧迫感/不耐烦与冠心病事件发生的前瞻性队列研究,以证实或反驳来自病例对照研究的这些观察结果。

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