The significance of psychosocial factors in predicting coronary disease in patients with valvular heart disease.

Several prognostic indices for predicting various aspects of coronary artery disease were significantly improved by the inclusion of psychosocial factors. 218 patients with valvular heart disease who had undergone routine coronary arteriography before valve replacement were studied in terms of cigarettes smoked, family history of ischaemic heart disease, HDL:cholesterol ratio, angina, sex, blood pressure and four psychosocial characteristics (i.e. social support, work stress, life events and Type A behavior). It was found that the psychosocial factors improved the preoperative predictive power of significant coronary artery disease on four criteria: previous history of hypertension, previous history of myocardial infarction, signs of peripheral vascular disease and ECG evidence of myocardial infarction.