Department of Psychology, Yonsei University, Seoul, Korea.
Division of Cardiology, School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Korean Circ J. 2015 Mar;45(2):117-24. doi: 10.4070/kcj.2015.45.2.117. Epub 2015 Mar 24.
Increasing evidence supports that psychological factors may be related to development of coronary artery disease (CAD). Although psychological well-being, ill-being, and control strategy factors may play a significant role in CAD, rarely have these factors been simultaneously examined previously. We assessed comprehensive psychological factors in patients with acute coronary syndrome (ACS).
A total of 85 ACS patients (56 unstable angina, 29 acute myocardial infarction; 52.6±10.2 years; M/F=68/17) and 63 healthy controls (48.7±6.7 years, M/F=43/20) were included. Socio-demographic information, levels of psychological maladjustment, such as anxiety, hostility, and job stress, health-related quality of life (HRQoL), and primary and secondary control strategy use were collected through self-report questionnaires.
There was no significant difference between the ACS group and control group in levels of anxiety, hostility, and job stress. However, ACS patients had significantly lower scores on the general health perception and bodily pain subscales of HRQoL than the control group. The ACS group, as compared with the controls, tended to use primary control strategies more, although not reaching statistical significance by univariate analysis. Multivariate logistic regression analysis after adjusting age and gender identified the physical domain of HRQoL {odds ratio (OR)=0.40}, primary control strategy (OR=1.92), and secondary control strategy (OR=0.53) as independent predictors of ACS.
Poor HRQoL and primary control strategy, proactive behaviors in achieving ones' goal, may act as risk factors for ACS, while secondary control strategy to conform to current situation may act as a protective factor for ACS.
越来越多的证据表明，心理因素可能与冠状动脉疾病（CAD）的发生有关。尽管心理幸福感、不幸福感和控制策略因素可能在 CAD 中发挥重要作用，但以前很少同时检查这些因素。我们评估了急性冠状动脉综合征（ACS）患者的综合心理因素。
共纳入 85 例 ACS 患者（不稳定型心绞痛 56 例，急性心肌梗死 29 例；52.6±10.2 岁；男/女=68/17）和 63 名健康对照者（48.7±6.7 岁，男/女=43/20）。通过自我报告问卷收集社会人口统计学信息、心理失调水平（如焦虑、敌意和工作压力）、健康相关生活质量（HRQoL）以及主要和次要控制策略的使用情况。
ACS 组和对照组在焦虑、敌意和工作压力水平方面无显著差异。然而，ACS 患者在 HRQoL 的一般健康感知和身体疼痛子量表上的得分明显低于对照组。与对照组相比，ACS 组更倾向于使用主要控制策略，尽管单因素分析未达到统计学意义。在调整年龄和性别后进行的多变量逻辑回归分析确定 HRQoL 的生理领域（OR=0.40）、主要控制策略（OR=1.92）和次要控制策略（OR=0.53）是 ACS 的独立预测因素。
较差的 HRQoL 和主要控制策略，即实现目标的积极行为，可能是 ACS 的危险因素，而顺应现状的次要控制策略可能是 ACS 的保护因素。
