Abstract P124: Perceived Stress in Acute Myocardial Infarction: Associations with Long-Term Health Status Outcomes

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Suzanne V Arnold ◽  
Kim G Smolderen ◽  
Donna M Buchanan ◽  
Yan Li ◽  
John A Spertus
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Status ◽  
Chronic Stress ◽  
Perceived Stress ◽  
High Stress ◽  
Angina Frequency ◽  
Physical Limitations ◽  
Independent Association ◽  
Disease Specific

Background: Chronic stress is associated with adverse prognosis in cardiovascular disease, but little is known about its link with health status. We studied the association between chronic stress and health status following acute myocardial infarction (AMI). Methods: In the 24 center US TRIUMPH registry, 4204 AMI patients completed the Perceived Stress Scale-4 (scores range 0-16) during hospitalization. Moderate/high stress over the prior month was defined as scores in the top 2 quintiles (scores=6-16). Patients were assessed at 1 year for disease-specific health status with the Seattle Angina Questionnaire (SAQ) and for generic health status with a Visual Analog Scale (VAS) and the SF-12. Multivariable logistic regression evaluated the independent association between moderate/high stress and poor health status (defined as SAQ angina frequency <100; SAQ physical limitations <75; SAQ QOL <75; VAS <65; SF-12 physical <35; and SF-12 mental <45). Results: After extensive adjustment for demographic, socio-economic and clinical characteristics (including depressive symptoms), AMI patients with moderate/high stress had a greater likelihood of angina and poor disease-specific and generic health status (Figure; p<0.01 for all). Conclusion: Moderate/high stress at the time of an AMI is associated with poor post-AMI health status, even after adjustment for important confounders. Future studies need to examine whether stress mediates observed racial and socio-economic disparities, and whether novel interventions targeting chronic stress can improve post-AMI health status.

scholarly journals Sex differences in health outcomes at one year following acute myocardial infarction: A report from the China Patient-Centered Evaluative Assessment of Cardiac Events prospective acute myocardial infarction study

2018 ◽  
Vol 8 (3) ◽  
pp. 273-282 ◽  
Author(s):  
Rachel P Dreyer ◽  
Xin Zheng ◽  
Xiao Xu ◽  
Shuling Liu ◽  
Jing Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Status ◽  
Standard Error ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
One Year ◽  
Disease Specific

Background: We examined sex differences in long-term health outcomes following acute myocardial infarction in China, including mortality, major adverse cardiac events and health status (symptoms, functioning, quality of life). Methods: A total of 3415 acute myocardial infarction patients (23.2% women) aged ⩾18 years were enrolled across 10 geographic regions in China (2012–2014) in the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) study. Clinical data was abstracted from medical records. Generic (Euro-Quality of Life Scale) and disease-specific (Seattle Angina Questionnaire) health status was obtained through interviews at baseline and one year. Results: At one year, women with acute myocardial infarction had a higher risk of death from all causes ( p<0.001), but had similar rates of major adverse cardiac events ( p=0.2). Women had lower mean generic (Euro-Quality of Life Scale utility index score: 0.90±0.13 vs 0.94±0.11) and disease specific health scores indicating poorer functioning (Seattle Angina Questionnaire summary score: 75.3±11.4 vs 78.4±9.7) and higher rates of daily/weekly angina (Seattle Angina Questionnaire angina frequency score ⩽60 vs >60: 9.1% vs 4.7%; all p<0.001). In multivariable analysis, there was a significant association between female sex and mortality (β=0.45, standard error=0.21, p=0.03) but not for major adverse cardiac events (β=−0.02, standard error=0.14, p=0.89). The association between female sex and worse generic health status persisted (β=−0.02, standard error=0.01, p=0.003), but was no longer significant between sexes for disease-specific health status (β=−0.82, standard error=0.58, p=0.154) or daily/weekly angina (odds ratio=1.39; 95% confidence interval 0.88–2.21). Conclusion: Women in China have higher crude rates of all-cause/cardiovascular death versus men, as well as worse generic/disease specific health status at one-year post-acute myocardial infarction. The association between female sex and worse generic health status persisted following adjustment.

scholarly journals Newly diagnosed diabetes and outcomes after acute myocardial infarction in young adults

Heart ◽  
2020 ◽  
pp. heartjnl-2020-317101 ◽  
Author(s):  
Qinglan Ding ◽  
Erica S Spatz ◽  
Kasia J Lipska ◽  
Haiqun Lin ◽  
John A Spertus ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Status ◽  
Pharmacological Treatment ◽  
Diabetes Education ◽  
Discharge Diagnosis ◽  
Newly Diagnosed ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes ◽  
Disease Specific

ObjectiveTo examine prevalence and characteristics of newly diagnosed diabetes (NDD) in younger adults hospitalised with acute myocardial infarction (AMI) and investigate whether NDD is associated with health status and clinical outcomes over 12-month post-AMI.MethodsIn individuals (18–55 years) admitted with AMI, without established diabetes, we defined NDD as (1) baseline or 1-month HbA1c≥6.5%; (2) discharge diabetes diagnosis or (3) diabetes medication initiation within 1 month. We compared baseline characteristics of NDD, established diabetes and no diabetes, and their associations with baseline, 1-month and 12-month health status (angina-specific and non-disease specific), mortality and in-hospital complications.ResultsAmong 3501 patients in Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients study, 14.5% met NDD criteria. Among 508 patients with NDD, 35 (6.9%) received discharge diagnosis, 91 (17.9%) received discharge diabetes education and 14 (2.8%) initiated pharmacological treatment within 1 month. NDD was more common in non-White (OR 1.58, 95% CI 1.23 to 2.03), obese (OR 1.72, 95% CI 1.39 to 2.12), financially stressed patients (OR 1.27, 95% CI 1.02 to 1.58). Compared with established diabetes, NDD was independently associated with better disease-specific health status and quality of life (p≤0.04). No significant differences were found in unadjusted in-hospital mortality and complications between NDD and established or no diabetes.ConclusionsNDD was common among adults≤55 years admitted with AMI and was more frequent in non-White, obese, financially stressed individuals. Under 20% of patients with NDD received discharge diagnosis or initiated discharge diabetes education or pharmacological treatment within 1 month post-AMI. NDD was not associated with increased risk of worse short-term health status compared with risk noted for established diabetes.Trial registration numberNCT00597922.

scholarly journals Sex Differences in Perceived Stress and Early Recovery in Young and Middle-Aged Patients With Acute Myocardial Infarction

Circulation ◽  
2015 ◽  
Vol 131 (7) ◽  
pp. 614-623 ◽  
Author(s):  
Xiao Xu ◽  
Haikun Bao ◽  
Kelly Strait ◽  
John A. Spertus ◽  
Judith H. Lichtman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Sex Differences ◽  
Perceived Stress ◽  
Middle Aged ◽  
Early Recovery ◽  
Aged Patients

Abstract P208: Functional Status, Rehospitalization, and Mortality Outcomes Among Acute Myocardial Infarction Patients with Prior and New-Onset Atrial Fibrillation

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Kyle P Hornsby ◽  
Kensey Gosch ◽  
Amy L Miller ◽  
Jonathan P Piccini ◽  
Renato D Lopes ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Health Status ◽  
Functional Status ◽  
Physical Function ◽  
Adverse Outcomes ◽  
Increased Risk ◽  
New Onset

Background: Little data are available regarding differences in prognosis and health status between new-onset and prior atrial fibrillation (AF) among patients with acute myocardial infarction (AMI). Methods: The TRIUMPH study enrolled 4340 AMI patients who received longitudinal follow-up including SF-12 health status assessments through 1 year post-AMI. We compared 1-year mortality, rehospitalization, and functional status according to AF type (none, prior, new) after adjusting for differences in baseline characteristics. Results: A total of 212 AMI patients (4.9%) had prior AF and 254 (5.9%) had new-onset AF. Compared with no AF, new AF was associated with older age, male sex, first MI, worse baseline physical function, home atrioventricular nodal blocker use, and worse ventricular function (c-index 0.77). Rates of 1-year mortality were 6.2%, 14.5%, and 13.0%, and 1-year rehospitalization rates were 29.1%, 44.2%, and 36.8% for no, prior, and new AF, respectively. After multivariable adjustment, neither prior nor new AF was associated with increased 1-year mortality, and only prior AF was associated with increased risk of 1-year rehospitalization (Figure). After adjusting for baseline SF-12 physical function scores, patients with prior AF had lower 1-year scores than those with no AF (40.6 vs. 43.7, p <0.003), whereas patients with new AF had similar scores (42.9 vs. 43.7, p=0.36). Conclusion: New-onset AF during AMI is associated with a number of comorbidities but, unlike prior AF, is not associated with adverse outcomes. These results raise the question of whether AF is itself a cause of or simply a marker of comorbidities leading to downstream adverse outcomes after AMI.

Abstract 110: Long-Term Health Status Outcomes in Young Women with Acute Myocardial Infarction: Results from the VIRGO Study

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Rachel P Dreyer ◽  
Kelly M Strait ◽  
Judith H Lichtman ◽  
Nancy Lorenze ◽  
Gail D'Onofrio ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Status ◽  
Young Women ◽  
Short Form ◽  
P Values ◽  
Poor Outcome

Background: Despite the excess risk of mortality in young women following acute myocardial infarction (AMI), little effort has been made to describe their long-term outcomes, particularly with respect to their health status (symptoms, function and quality of life). Accordingly, we assessed gender differences in 1-year health status outcomes after AMI. Methods: Data was used from the VIRGO study, an observational cohort of patients aged ≤55 years with AMI in the US and Spain (n=3,501, 67% women). Clinical data was abstracted from medical records and health status was obtained through patient interviews at the time of hospitalization and at 1-year later [Short Form 12 (SF-12) and the Seattle Angina Questionnaire (SAQ)]. Patient scores were categorized as “bad” if they had below average scores on the SF-12 components, had a score below 100 on the SAQ physical limitations (PL) or the SAQ angina frequency (AF), or had a score below 75 on the SAQ quality of life (QOL) at either baseline or 1-year. Patients were classified as having a “poor” outcome for a measure if they had a “bad” score at both baseline and 1-year or had a “bad” score at 1-year. Logistic regression models were used to assess factors associated with having a “poor” outcome for each scale. Results: The median age was 48 years (IQR: 44, 52). Women were more likely to present with diabetes (39% vs. 27%), obesity (51% vs. 45%), stroke (5% vs. 2%), heart failure (5% vs. 2%), lung disease (13% vs. 5%), and depression (48% vs. 24%, all P values <0.0001). Women were more likely to have “poor outcomes” compared with men (SF-12 PCS 46% vs. 30%; SF-12 MCS 47% vs. 30%; SAQ AF 32% vs. 25%; SAQ PL 29% vs. 20%; SAQ QOL 42% vs. 28%, all p-values <0.001). Female gender, prior AMI/percutaneous coronary intervention/coronary artery bypass grafting, and smoking within 30 days were independent predictors of having a “poor” outcome for all health status measures. Specifically, women had an increased odds of having a “poor” outcome on the SF-12 PCS (OR=2.05; 95% CI 1.69, 2.48), MCS (OR=1.98; 95% CI 1.65, 2.39), SAQ AF (OR=1.39; 95% CI 1.15, 1.67), SAQ PL (OR=1.62; 95% CI 1.32, 1.99) and the SAQ QOL scale (OR=1.84; 95% CI 1.53, 2.22), as compared with men. Conclusion: Compared with men, young women are more likely to have “poor” health status outcomes after AMI. This information is critically important in developing targets for gender-specific interventions to improve young women’s recovery post AMI.

Abstract P295: The Association of Chronic Stress with Obesity among Hispanic/Latino Adults. Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Carmen R Isasi ◽  
Christina M Parrinelo ◽  
Linda C Gallo ◽  
Mercedes R Carnethon ◽  
Orit Birnbaum-Weitzman ◽  
...  
Keyword(s):  
Chronic Stress ◽  
Perceived Stress ◽  
Traumatic Stress ◽  
High Stress ◽  
Normal Weight ◽  
Health Study ◽  
Obesity Prevalence ◽  
Multinomial Regression ◽  
Multicenter Cohort Study ◽  
Latino Adults

Objectives: Prior studies suggest that high stress levels are associated with obesity. However, few studies distinguish between type, duration or timing of stressful exposures. In this study, we examined the association of chronic and recent stress with excess weight in a diverse sample of Latino adults. Methods: HCHS/SOL is a multicenter cohort study of Latino adults (ages 18-74 years) from 4 US cities (Bronx, Chicago, Miami and San Diego).The Sociocultural Ancillary Study (2009-2011) is a sample of 5,253 participants (61% female) from HCHS/SOL. Overweight was defined as BMI 25-29.9 and Obese as BMI ≥30. Three indicators of stress were studied: chronic stress lasting for at least 6 months (Chronic Burden Scale), lifetime exposure to stressors (Traumatic Stress Schedule), and perceived stress during the last month (past month, Cohen’s Perceived Stress Scale). Odds ratios (OR) were calculated using multinomial regression models to describe the odds of obesity or overweight relative to normal weight; models were adjusted for study sampling design and potential confounders. Results: 37% of participants were overweight and 41% obese. Mean (standard error) scores of chronic stress, traumatic stress and perceived stress were 1.8 (0.04), 2.1 (.04), and 14.9 (0.16), respectively. After adjustment for confounders, the odds of obesity increased with number of chronic stress events. A higher number of traumatic events were associated with overweight but the association was not longer significant after adjustment for confounders (Table). No association between perceived stress with overweight or obesity was observed. Conclusions: Exposure to chronic stressors lasting ≥6 months is more relevant for obesity prevalence than recent exposure (past month) in Hispanics. As high stress and obesity are important problems among Hispanics, stress management techniques may need to be incorporated in obesity prevention and treatment programs for this population.

scholarly journals OBESITY PARADOX AND ANGINA FREQUENCY IN PATIENTS PRESENTING WITH ACUTE MYOCARDIAL INFARCTION

2014 ◽  
Vol 63 (12) ◽  
pp. A267
Author(s):  
Praneet Sharma ◽  
Donna Buchanan ◽  
Philip Jones ◽  
Stacie Daugherty ◽  
Faraz Kureshi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Obesity Paradox ◽  
Angina Frequency

Trends in the Health Status of Older Manitobans, 1985 to 1999

2005 ◽  
Vol 24 (S1) ◽  
pp. 5-14 ◽  
Author(s):  
Verena H. Menec ◽  
Lisa Lix ◽  
Leonard MacWilliam
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Status ◽  
Urban Areas ◽  
Health Indicators ◽  
Health Gains ◽  
Senior Population ◽  
Prevalence Of Obesity ◽  
Number Of Individuals ◽  
Significant Health

ABSTRACTTrends in the health status of the entire senior population aged 65 years or older in Manitoba were examined over a 14-year period (1985–1999) using administrative data (about 150,000 individuals). Significant health gains were apparent for a number of important indicators, including acute myocardial infarction, stroke, cancer, and hip fractures, although some of these gains were restricted to urban areas. Improvements in these health indicators are significant, as they can have major implications for individuals' need for health services and ability to live independently. In contrast, chronic diseases were on the rise, with the prevalence of diabetes, hypertension, and dementia increasing substantially over the 14-year period. These trends suggest a need for a policy emphasis on prevention, such as reducing the prevalence of obesity, which is one risk factor for diabetes. Moreover, having sufficient care options in place for the growing number of individuals with dementia is an issue that will have to be addressed.

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