Kahraman Serkan, Cam Kahraman Fatma, Zencirkiran Agus Hicaz, Kalkan Ali Kemal, Uzun Fatih, Karakayalı Muammer, Altunova Mehmet, Sevinç Samet, Demir Ali Rıza, Yılmaz Emre, Ertürk Mehmet
Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Training and Research Hospital, Istanbul, Turkey.
Department of Psychology, Istanbul Kent University, Faculty of Humanities and Social Sciences, Istanbul, Turkey.
Turk Kardiyol Dern Ars. 2020 Jul;48(5):494-503. doi: 10.5543/tkda.2020.30020.
Stress is known to be a significant risk factor for coronary atherosclerosis and adverse cardiovascular events; however, the stress-related coronary atherosclerotic burden has not yet been investigated. The aim of this study was to investigate the relationship between the Perceived Stress Scale (PSS) and the SYNTAX scores in patients with ST-segment elevation myocardial infarction (STEMI).
A total of 440 patients with STEMI were prospectively enrolled and divided into 2 groups according to the PSS score with a ROC curve analysis cut-off value of 17.5. In all, 361 patients with a low PSS score were categorized as Group 1 and 79 patients with a high PSS score were categorized as Group 2.
The SYNTAX score [Group 1, 16.0 (10.0-22.5); Group 2, 22.5 (15.0-25.5); p<0.001] and the SYNTAX score II were significantly higher in Group 2 [Group 1, 24.8 (19.0-32.6); Group 2, 30.9 (22.3-38.9); p<0.001]. Spearman analysis demonstrated that the PSS score was associated with the SYNTAX score (r=0.153; p=0.001) and the SYNTAX score II (r=0.216; p<0.001). Additionally, the PSS (odds ratio: 2.434, confidence interval: 1.446-4.096; p=0.001) was determined to be an independent predictor of a moderate-to-high SYNTAX score. The PSS score of patients with in-hospital mortality was also higher than those who survived [15 (10-20); 9 (4-16), respectively; p=0.007].
Stress appears to accelerate the coronary atherosclerotic process and the associated burden. An increased stress level was found to be an independent predictor of a high SYNTAX score.
已知压力是冠状动脉粥样硬化和不良心血管事件的重要危险因素；然而，与压力相关的冠状动脉粥样硬化负担尚未得到研究。本研究的目的是调查ST段抬高型心肌梗死（STEMI）患者的感知压力量表（PSS）与SYNTAX评分之间的关系。
前瞻性纳入440例STEMI患者，并根据PSS评分（ROC曲线分析临界值为17.5）分为2组。共有361例PSS评分低的患者被归类为第1组，79例PSS评分高的患者被归类为第2组。
第2组的SYNTAX评分[第1组，16.0（10.0 - 22.5）；第2组，22.5（15.0 - 25.5）；p<0.001]和SYNTAX评分II显著更高[第1组，24.8（19.0 - 32.6）；第2组，30.9（22.3 - 38.9）；p<0.001]。Spearman分析表明，PSS评分与SYNTAX评分（r = 0.153；p = 0.001）和SYNTAX评分II（r = 0.216；p<0.001）相关。此外，PSS（比值比：2.434，置信区间：1.446 - 4.096；p = 0.001）被确定为中至高SYNTAX评分的独立预测因子。院内死亡患者的PSS评分也高于存活患者[分别为15（10 - 20）；9（4 - 16）；p = 0.007]。
压力似乎会加速冠状动脉粥样硬化进程及相关负担。压力水平升高是高SYNTAX评分的独立预测因子。
