scholarly journals High Perceived Stress May Shorten Activated Partial Thromboplastin Time and Lead to Worse Clinical Outcomes in Patients With Coronary Heart Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Han Yin ◽  
Xingyu Cheng ◽  
Yanting Liang ◽  
Anbang Liu ◽  
Haochen Wang ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Clinical Outcomes ◽  
Perceived Stress ◽  
Partial Thromboplastin Time ◽  
Single Point ◽  
Activated Partial Thromboplastin Time ◽  
Psychological Status ◽  
Predictive Values ◽  
Coagulation Function

Objective: To determine the association of perceived stress with coagulation function and their predictive values for clinical outcomes.Methods: This prospective cohort study derived from a cross-sectional study for investigating the psychological status of inpatients with suspicious coronary heart disease (CHD). In this study, the 10-item Perceived Stress Scale (PSS-10) as an optional questionnaire was used to assess the severity of perceived stress. Coagulation function tests, such as activated partial thromboplastin time (APTT), prothrombin time (PT), and fibrinogen were measured within 1 h after admission. Furthermore, 241 patients with CHD out of 705 consecutive inpatients were included in the analyses and followed with a median of 26 months for the clinical outcomes.Results: The patients in high perceived stress status (PSS-10 score > 16) were with shorter APTT (36.71 vs. 38.45 s, p = 0.009). Shortened APTT ( ≤ 35.0 s) correlated with higher PSS-10 score (14.67 vs. 11.22, p = 0.003). The association of APTT with depression or anxiety was not found. Multiple linear models adjusting for PT estimated that every single point increase in PSS-10 was relevant to approximately 0.13 s decrease in APTT (p = 0.001) regardless of the type of CHD. APTT (every 5 s increase: hazard ratio (HR) 0.68 [0.47–0.99], p = 0.041) and perceived stress (every 5 points increase: HR 1.31 [1.09–1.58], p = 0.005) could predict the cardiovascular outcomes. However, both predictive values would decrease when they were simultaneously adjusted. After adjusting for the physical clinical features, the associated of perceived stress on cardiac (HR 1.25 [1.04–1.51], p = 0.020) and composite clinical outcomes (HR 1.24 [1.05–1.47], p = 0.011) persisted.Conclusions: For the patients with CHD, perceived stress strongly correlates with APTT. The activation of the intrinsic coagulation pathway is one of the mechanisms that high perceived stress causes cardiovascular events. This hints at an important role of the interaction of mental stress and coagulation function on cardiovascular prognosis. More attention needs to be paid to the patients with CHD with high perceived stress.

Abstract 17352: Hand Grip Strength as a Predictor of Exercise Capacity in Coronary Heart Disease

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Cheol Ung Choi ◽  
Woohyeun Kim ◽  
Se-Hyun Park ◽  
Woo-Sub Kim ◽  
Won Young Jang ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Grip Strength ◽  
Exercise Capacity ◽  
Quadriceps Strength ◽  
Hand Grip Strength ◽  
Operating Characteristics ◽  
Predictive Values ◽  
Metabolic Equivalents ◽  
Hand Grip

Introduction: Exercise capacity is related to the prognosis of coronary heart disease (CHD). Recent study have shown that quadriceps strength can be used to predict exercise capacity levels in patients with CHD. Hypothesis: The aim of this study is to determine whether this relationship between muscular strength and exercise capacity is maintained in hand grip strength (HGS). Methods: We studied 310 participants (Age; 62.1 ± 11.5, Men; 77.4 %) who underwent coronary intervention and participated cardiac rehabilitation. Maximal HGS was expressed as absolute value (kg), and relative to bodyweight (%bodyweight). Logistic regression was used to assess the relationship of maximal HGS, age, sex, type of CHD, diabetes, hypertension, renal insufficiency, ejection fraction, body mass index, body weight, waist to hip ratio, and basal metabolic rate with distance walked on 6-minuite walk test (6MWT) and estimated metabolic equivalents (eMETs). Results: Maximal HGS was significantly related to distance walked on 6 MWT (r = 0.40 for %bodyweight, p < 0.001) and eMETs (r = 0.43 for %bodyweight, p < 0.001). Maximal HGS was the strongest predictor of exercise capacity in each distance walked on 6 MWT category. Receiver operating characteristics curves identified maximal HGS of 35.7, 42.0% bodyweight as the best predictive cut offs for 200, and 400 meters, respectively with positive predictive values of 0.64. They also identified HGS of 38.3, and 44.6% bodyweight as the best predictive cut offs for 6 and 8 eMETs, respectively with positive predictive values of 0.70. Conclusions: Maximal HGS is related with distance on 6 MWT and eMETs levels at exercise test in CHD patients. This result suggests that maximal HGS can be used to predict exercise capacity levels. Based on this result, prospective study investigating the association between HGS and clinical outcome of CHD is needed.

scholarly journals Clinical outcomes with unfractionated heparin monitored by anti‐factor Xa vs. activated partial Thromboplastin time

2019 ◽  
Vol 94 (9) ◽  
pp. 1015-1019 ◽  
Author(s):  
James C. Coons ◽  
Carlo J. Iasella ◽  
Megan Thornberg ◽  
Mary Grace Fitzmaurice ◽  
Kimberly Goehring ◽  
...  
Keyword(s):  
Unfractionated Heparin ◽  
Clinical Outcomes ◽  
Partial Thromboplastin Time ◽  
Factor Xa ◽  
Activated Partial Thromboplastin Time

scholarly journals Meta-Analysis of Perceived Stress and Its Association With Incident Coronary Heart Disease

2012 ◽  
Vol 110 (12) ◽  
pp. 1711-1716 ◽  
Author(s):  
Safiya Richardson ◽  
Jonathan A. Shaffer ◽  
Louise Falzon ◽  
David Krupka ◽  
Karina W. Davidson ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Perceived Stress ◽  
Meta Analysis ◽  
Incident Coronary Heart Disease

Effective Techniques in Coronary Heart Disease Interventions: A meta-analysis (Preprint)

2022 ◽  
Author(s):  
Eunice Eno Yaa Frimponmaa Agyei ◽  
Juoko Miettunen ◽  
Harri Oinas-Kukkonen
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Clinical Outcomes ◽  
Social Role ◽  
Digital Health ◽  
Meta Analysis ◽  
Systems Design ◽  
Digital Interventions ◽  
Behavior Change Interventions ◽  
Learning Principles

BACKGROUND Coronary heart disease (CHD) is a major cause of death worldwide. OBJECTIVE In this research, we investigated the effectiveness of digital interventions designed for the prevention and management of CHD. METHODS We searched three academic databases for scientific papers on CHD and digital interventions from 2004 to 2020, yielding 1706 papers and 1556 papers after deduplication. We further screened the titles and abstracts, excluding irrelevant papers, leaving 28 papers. A further nine papers were retrieved and included in the analysis through forward and backward referencing. We conducted meta-analysis using 13 of the 37 papers that fit the criteria for meta-analysis. We identified and classified intervention features using the Persuasive Systems Design model. Our findings show that digital health interventions had an impact on all clinical outcomes except Body Mass Index. RESULTS We present (1) intervention features that were associated with positive clinical outcomes, and (2) successful and unsuccessful interventions and the persuasive software features incorporated in them. Reminders, verifiability, social role, expertise, authority, tailoring, personalization, self-monitoring, praise, suggestion, and social learning principles were incorporated in interventions that succeeded in improving clinical outcomes. CONCLUSIONS Our research provides insights into persuasive software features that maintain powers to influence the effectiveness of CHD behavior change interventions.

P191 The effectiveness of mindfulness-based interventions on perceived stress, depression and anxiety in patients with coronary heart disease: A systematic review and meta-analysis

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
H Zou ◽  
S Y Chair ◽  
X Cao
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Active Control ◽  
Perceived Stress ◽  
Psychological Health ◽  
Meta Analysis ◽  
Small Sample ◽  
Significant Heterogeneity ◽  
Depression And Anxiety ◽  
Post Intervention

Abstract Background An increasing number of people are living with coronary heart disease (CHD) globally. Psychological conditions such as stress, depression, and anxiety are prevalent for people with CHD, which impose a great challenge for secondary prevention of CHD. Mindfulness-based interventions (MBIs), which incorporate mindfulness skills and cognitive or behavioural therapy, are suggested as a promising approach to help patients with CHD to improve their psychological health. However, the effectiveness of MBIs for patients with CHD has not been systematically reviewed. Purpose To synthesise the evidence regarding the effects of MBIs on reducing perceived stress, depression, and anxiety in patients with CHD. Methods   Search was conducted in seven English electronic databases and two Chinese electronic databases from inception to January 2019. Randomized controlled trials (RCTs) that evaluated the effects of MBIs on stress, depression, and anxiety in adults with CHD were included. Two reviewers independently screened records for eligibility, extracted data, and assessed risks of bias using the Cochrane tool. Meta-analysis was conducted by combining the standard mean difference (SMD) with 95% confidence interval (CI) of post-intervention outcome measures using Review Manager Version 5.3. We used a fixed-effects model if no significant heterogeneity (I² &lt; 50%), while in case of significant heterogeneity (50% &lt; I² &lt; 75%), we used a random-effects model. Results Six RCTs involving 473 participants were included. Five of all studies compared MBIs with inactive controls (i.e., usual care and waitlist control). The remaining study utilized a self-help group that received a booklet containing identical mindfulness information as an active control. There were high concerns about the risk of bias across studies, mainly in performance bias and detection bias. The meta-analysis of two studies showed MBIs may reduce perceived stress at post-intervention (SMD -0.82; 95% CI -1.28 to -0.36; P &lt; 0.001; I² 0%) compared with inactive controls. Compared with active control, the single study did not observe a significant reduction of perceived stress in intervention group. The meta-analysis of five studies revealed that MBIs appear effective in reducing depression (SMD -1.08; 95% CI -1.28 to -0.87; P &lt; 0.001; I² 22%) and anxiety (SMD -1.16; 95% CI -1.57 to -0.75; P &lt; 0.001; I² 71%) immediately after intervention, compared with inactive or active controls. Conclusions The results of this review provide evidence for the effects of MBIs on reduction in perceived stress, depression and anxiety at post-intervention in patients with CHD. However, these findings need to be interpreted with caution given the small sample size and methodological limitations within included studies. Rigorous-designed research is urgently needed to further confirm the effectiveness of MBIs on improving psychological health and explore its sustainable effects in patients with CHD.

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