Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
BMC Cardiovasc Disord. 2011 Jul 21;11:45. doi: 10.1186/1471-2261-11-45.
Psychosocial stress has been identified as a risk factor in association with cardiovascular disease but less attention has been paid to heterogeneity in vulnerability to stress. The serial Color Word Test (CWT) measures adaptation to a stressful situation and it can be used to identify individuals that are vulnerable to stress. Prospective studies have shown that individuals with a maladaptive behavior in this test are exposed to an increased risk of future cardiovascular events. The aim of the present study was to investigate whether maladaptive behavior in the serial CWT alone or in combination with any specific personality dimension was associated with severity of myocardial infarction (MI).
MI-patients (n = 147) completed the test and filled in a personality questionnaire in close proximity to the acute event. The results were analyzed in association with four indicators of severity: maximum levels above median of the cardiac biomarkers troponin I and creatine kinase-MB (CKMB), Q-wave infarctions, and a left ventricular ejection fraction (LVEF) ≤ 50%.
Maladaptive behavior in the serial CWT together with low scores on extraversion were associated with maximum levels above median of cardiac troponin I (OR 2.97, CI 1.08-8.20, p = 0.04) and CKMB (OR 3.33, CI 1.12-9.93, p = 0.03). No associations were found between the combination maladaptive behavior and low scores on extraversion and Q-wave infarctions or a decreased LVEF.
Maladaptive behavior in combination with low scores on extraversion is associated with higher cardiac biomarker levels following an MI. The serial CWT and personality questionnaires could be used to identify individuals vulnerable to the hazardous effects of stress and thereby are exposed to an increased risk of a more severe infarction.
心理社会压力已被确定为与心血管疾病相关的风险因素，但对压力易感性的异质性关注较少。连续色词测试（CWT）可测量对紧张情况的适应能力，可用于识别易受压力影响的个体。前瞻性研究表明，在该测试中表现出适应不良行为的个体未来发生心血管事件的风险增加。本研究旨在探讨连续 CWT 中的适应不良行为，或与特定人格维度结合，是否与心肌梗死（MI）的严重程度相关。
MI 患者（n=147）在急性事件发生前后不久完成了该测试并填写了人格问卷。结果与四个严重程度指标相关联：心脏生物标志物肌钙蛋白 I 和肌酸激酶同工酶-MB（CKMB）的中位数以上的最大水平、Q 波梗死和左心室射血分数（LVEF）≤50%。
连续 CWT 中的适应不良行为加上外向性得分低与肌钙蛋白 I（OR 2.97，CI 1.08-8.20，p=0.04）和 CKMB（OR 3.33，CI 1.12-9.93，p=0.03）的中位数以上最大水平相关。适应不良行为与外向性得分低的组合与 Q 波梗死或 LVEF 降低之间无关联。
MI 后，连续 CWT 中的适应不良行为与外向性得分低与更高的心脏生物标志物水平相关。连续 CWT 和人格问卷可用于识别易受压力有害影响的个体，从而增加发生更严重梗死的风险。
