de Faire U, Theorell T
Scand J Soc Med. 1976;4(3):115-22.
Although statistically significant, the relation between certain life changes and imminent myocardial infarction appears to be quantitatively weak. Of particular importance are events connected with employment. However, the summation of life changes has not proved to be of use in the prediction of imminent myocardial infarction. For patients with ischemic heart disease, variations in life change measures have proved to be of use in the prediction of changes in catecholamine output and in prognosis. When genetic factors are held constant, as in monozygotic twin pairs vulnerable to ischemic heart disease, more life changes in one partner may indicate a greater risk of unexpected sudden cardiac death in this partner than in the other twin. The self-rating of the severity of each experienced event has proved more useful than "standard weights" in the retrospective discrimination of myocardial infarction patients. Further clinical and epidemiological studies are needed in this field. For the future, the following recommendations are made: The studies should be prospective. The individual's habitual level and actual level of the change should be recorded. The severity of events should be self-rated. Risk variables, known to be of importance to the development of MI should be recorded. They are for instance smoking habits, blood pressure, serum lipids and genetic predisposition. Psychological variables should be mentioned separately in this connection.
尽管具有统计学意义，但某些生活变化与即将发生的心肌梗死之间的关系在数量上似乎较弱。与就业相关的事件尤为重要。然而，生活变化的总和尚未被证明对预测即将发生的心肌梗死有用。对于缺血性心脏病患者，生活变化指标的变化已被证明对预测儿茶酚胺输出的变化和预后有用。当遗传因素保持恒定时，如在易患缺血性心脏病的同卵双胞胎中，一方经历的生活变化更多可能表明该方比另一方双胞胎发生意外心源性猝死的风险更高。在对心肌梗死患者进行回顾性鉴别时，事实证明对每个经历事件的严重程度进行自我评估比“标准权重”更有用。该领域需要进一步的临床和流行病学研究。对于未来，提出以下建议：研究应具有前瞻性。应记录个体变化的习惯水平和实际水平。事件的严重程度应由个体进行自我评估。应记录已知对心肌梗死发生具有重要意义的风险变量。例如吸烟习惯、血压、血脂和遗传易感性。在此方面，心理变量应单独提及。
