Khan Mohammad Asghar, Karamat Mehwish, Hafizullah Mohammad, Nazar Zahid, Fahim Muhammad, Gul Adnan Mehmood
Department of Cardiology, Lady Reading Hospital, Peshawar, Pakistan.
J Ayub Med Coll Abbottabad. 2010 Apr-Jun;22(2):32-5.
The impact of psychological factors in acute coronary events is only now emerging. A growing body of evidence attests to the influence of emotional and stress-related psychosocial factors in the aetiology of Coronary Artery Disease (CAD) and morbidity and mortality among individuals with coronary heart disease. The objectives were to look for the frequency of anxiety and psychosocial stressful events in patients with acute myocardial infarction.
Two hundred consecutive patients of Acute Myocardial Infarction (AMI) without complications who presented to the Coronary Care Unit of Cardiology Department, Lady Reading Hospital Peshawar, and 200 healthy controls among relatives of patients were assessed on Holmes Rahe Social scale (HRS) and Hospital Anxiety and Depression Scale (HADS) scale for the presence of anxiety and stressful life events in period preceding AMI.
Sixty-three percent of the patients were male in both groups. Mean age of patients was 59 years while that of controls was 52 years. For scores of anxiety on HADS, 34% of the controls had normal score compared to of the 19% AMI group (p<0.001), while 57% of the AMI patients had abnormal score compared to 39% of the control group (p<0.001). The number events reported on HRS scale in patients with AMI were significantly more (4.2 +/- 2) compared to the number of events (2.7 +/- 1.6) in the control group with (p<0.001). Scores for the number of events on HRS scale were significantly less (98 +/- 64) in controls compared to (158 +/- 5.8) in group with AMI (p<0.001). Anxiety was diagnosed in 70% of the female patients compared to 50% of the male patients.
Significant number of patients with acute myocardial infarction when assessed on standard scales had anxiety and stressful life events in the weeks preceding the event. These were more common in female than male patients.
心理因素在急性冠脉事件中的影响目前才逐渐显现。越来越多的证据证明，情绪及与压力相关的社会心理因素在冠状动脉疾病（CAD）的病因以及冠心病患者的发病率和死亡率方面具有影响。目的是探寻急性心肌梗死患者中焦虑和社会心理应激事件的发生频率。
对在白沙瓦雷丁夫人医院心脏病科冠心病监护病房就诊的200例无并发症的急性心肌梗死（AMI）连续患者，以及患者亲属中的200名健康对照者，采用霍尔姆斯-拉赫社会量表（HRS）和医院焦虑抑郁量表（HADS），评估AMI发作前一段时间内焦虑和应激性生活事件的存在情况。
两组中63%的患者为男性。患者的平均年龄为59岁，而对照组为52岁。在HADS焦虑评分方面，34%的对照组得分正常，而AMI组为19%（p<0.001）；57%的AMI患者得分异常，而对照组为39%（p<0.001）。AMI患者在HRS量表上报告的事件数量（4.2±2）明显多于对照组的事件数量（2.7±1.6）（p<0.001）。对照组HRS量表上的事件数量得分（98±64）明显低于AMI组（158±5.8）（p<0.001）。70%的女性患者被诊断为焦虑，而男性患者为50%。
当采用标准量表评估时，相当数量的急性心肌梗死患者在发病前几周存在焦虑和应激性生活事件。这些在女性患者中比男性患者更常见。
